17 results
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Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
restriction alone in SIADH ... or Ineffective (UNa ... , Renal Sodium loss ... intake, UNa <20 ... #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 ... → Subclinical volume ... Pathophysiology #diagnosis #nephrology
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Volume Based Approach ... uric acid <4 • SIADH ... SatyaPatelMD #Volume ... algorithm #diagnosis #sodium ... #low #nephrology
Management of SIADH Treat underlying cause: • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... pain, primary lung ... administered • Can cause volume ... promoting passive sodium ... #hyponatremia #nephrology
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
- RAAS ON (UNa ... > 30): SIADH, Medications ... polydipsia, Low solute ... Algorithm #diagnosis #sodium ... #nephrology
SIADH Treatment Options 1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
Pain, Primary lung ... This can cause volume ... promoting passive sodium ... osmolality < 538 AND UNa ... #hyponatremia #nephrology
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Vasopressin-Dependent • UNa ... Cirrhosis • UNa ... Inappropriate - Consider: SIADH ... polydipsia, Low solute ... algorithm #causes #nephrology
Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Repeat the sodium ... Assess volume status ... • extra-renal volume ... EUVOLEMIC • SIADH ... Workup #Algorithm #Nephrology
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
Hypovolemic - Give volume ... 200 - Inadequate Solute ... , SSRIs) - SIADH ... Algorithm #diagnosis #nephrology ... #sodium
Hyponatremia Differential Diagnosis Table • Step 1: Correct for hyperglycemia. Corrected Na = [(glucose - 100)/
Corrected Na = [ ... Urine Osm • Na ... (FeNa) • Volume ... Diagnosis #Table #nephrology ... #sodium
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