16 results
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 ... renal failure #Hypernatremia
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Approach to Hypotonic Hyponatremia ... case of hypotonic hyponatremia ... or Ineffective (UNa ... Physiologic #Hypotonic #Hyponatremia ... #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic Hyponatremia ... irrigants Hypotonic Hyponatremia ... > 30): SIADH, Medications ... #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
to Hyponatremia ... uric acid <4 • SIADH ... #Hyponatremia # ... algorithm #diagnosis #sodium ... #low #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 ... Pathophysiology #diagnosis #nephrology ... #hyponatremia #
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Inappropriate - Consider: SIADH ... polydipsia, Low solute ... @NephroMD #hyponatremia ... algorithm #causes #nephrology
Hyponatremia Differential Diagnosis Table

 • Step 1: Correct for hyperglycemia. Corrected Na = [(glucose - 100)/
Hyponatremia Differential ... (FeNa) • Volume ... MatthewHoMD #Hyponatremia ... Diagnosis #Table #nephrology ... #sodium
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... administered • Can cause volume ... promoting passive sodium ... #Management #hyponatremia ... #nephrology #treatment
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... , SSRIs) - SIADH ... UnremarkableLab #Hyponatremia ... Algorithm #diagnosis #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 ... DrEricStrong #Hyponatremia ... Table #Causes #Sodium