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nephrology diagnosis algorithm management differential cancer cerebral comparison ebv hypotonic oncology osmolality pathophysiology physiologic potomania raas saltwasting table thiazides
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
- RAAS ON (UNa ... < 30): Hypovolemia ... - RAAS OFF (UNa ... > 30): SIADH, Medications ... Algorithm #diagnosis #sodium
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
or Ineffective (UNa ... (Uosm ≥100): SIADH ... , Renal Sodium loss ... solute intake, UNa ... , Hypervolemia with
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Salt Wasting vs SIADH ... Neurological event 2) Sodium ... → ADH → water reabsorption ... 5) ↓ Na+ → Subclinical ... diagnosis #nephrology #hyponatremia
Hyponatremia (<135 mEq/L) is a common electrolyte abnormality caused by an excess of total body water
concentration (UNa ... intravascular volume; UNa ... #hyponatremia #ADH ... EBV #potomania #SIADH ... #Thiazides #UNAa
Management of SIADH Treat underlying cause: • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
promoting passive sodium ... osmolality < 538 AND UNa ... antagonists: • Blocks ADH ... #Management #hyponatremia ... #nephrology #treatment
SIADH Treatment Options 1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... promoting passive sodium ... osmolality < 538 AND UNa ... vaptans) • Blocks ADH ... #Management #hyponatremia
Management of Hyponatremia Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125 Give
Management of Hyponatremia ... Normalizes in SIADH ... • IF SIADH — ... give specific treatment ... #sodium
Hyponatremia Differential Diagnosis Algorithm in Cancer UOsm ≥ 100 mOsm/kg = Urine is inappropriately concentrated for hypotonic
Vasopressin-dependent - UNa ... appropriate • Hypovolemia ... following HSCT) - UNa ... inappropriate • SIAD ... tumors, brain or lung
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