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diagnosis hyponatremia algorithm management table treatment causes low rheumatology abg acid acidbase adh base bilateral blines bloodgas cancer cerebral classification
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
restriction alone in SIADH ... , Renal Sodium loss ... solute intake, UNa ... #Hyponatremia #differential ... #nephrology
Management of SIADH Treat underlying cause: • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... pain, primary lung ... promoting passive sodium ... osmolality < 538 AND UNa ... #hyponatremia #nephrology
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Salt Wasting vs SIADH ... Neurological event 2) Sodium ... reabsorption 5) ↓ Na ... #SaltWasting #SIADH ... Pathophysiology #diagnosis #nephrology
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
- RAAS ON (UNa ... - RAAS OFF (UNa ... > 30): SIADH, Medications ... Algorithm #diagnosis #sodium ... #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Osmolarity 3) Urine Sodium ... Low Uric Acid → SIADH ... Diagnosis #Algorithm #nephrology ... #sodium #low #uricacid
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Vasopressin-Dependent • UNa ... Cirrhosis • UNa ... Inappropriate - Consider: SIADH ... hyponatremia #diagnosis #differential ... algorithm #causes #nephrology
SIADH Treatment Options 1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... Pain, Primary lung ... promoting passive sodium ... osmolality < 538 AND UNa ... #hyponatremia #nephrology
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
acid >4 • Urine Na ... losses • Urine Na ... uric acid <4 • SIADH ... algorithm #diagnosis #sodium ... #low #nephrology
Hyponatremia Differential Diagnosis Table • Step 1: Correct for hyperglycemia. Corrected Na = [(glucose - 100)/
Hyponatremia Differential ... Corrected Na = [ ... #Hyponatremia #Differential ... Diagnosis #Table #nephrology ... #sodium
Hyponatremia - Differential Diagnosis by Mechanism Decr Blood Pressure (“Decr Effective Circulating Volume”) - Volume depletion
Hyponatremia - Differential ... ADH secretion (SIADH ... carcinoma of the lung ... #Hyponatremia #Differential ... Table #Causes #Sodium
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