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nephrology algorithm differential management treatment causes clinical low table ultrasound workup hypernatremia hypotonic pneumonia abdominal adh bilateral blines cancer cerebral
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
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 ... #differential #diagnosis ... #table #sodium
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 ... Pathophysiology #diagnosis ... #nephrology #hyponatremia
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Vasopressin-Dependent • UNa ... Cirrhosis • UNa ... Inappropriate - Consider: SIADH ... #diagnosis #differential
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Osmolarity 3) Urine Sodium ... Low Uric Acid → SIADH ... #Differential #Diagnosis
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Based Approach to Hyponatremia ... uric acid <4 • SIADH ... SatyaPatelMD #Volume #Hyponatremia ... #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 ... promoting passive sodium ... osmolality < 538 AND UNa ... #Management #hyponatremia
Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... mmol/L - true hyponatremia ... EUVOLEMIC • SIADH ... #Diagnosis #Workup
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 ... #Management #hyponatremia
Hyponatremia - Diagnostic Evaluation Algorithm Step 1: Consider whether Posm may actually be normal or elevated Step 2:
Hyponatremia - Diagnostic ... status and measure UNa ... tests Step 5: If SIADH ... DrEricStrong #Hyponatremia ... #Diagnosis #Workup
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