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Polyuria - Differential Diagnosis Algorithm Urine Output > 3L /day Water Diuresis (Urine Osm <100 mOsm/kg) • Primary
Diuresis (Urine Osm ... <100 mOsm/kg) ... Central Diabetes Insipidus ... Nephrogenic Diabetes Insipidus ... 100-200 mOsm/kg
Central vs Nephrogenic Diabetes Insipidus - Desmopressin Challenge Give desmopressin (intranasal, SQ, IV) and monitor UOsm every
Nephrogenic Diabetes Insipidus ... IV) and monitor UOsm ... • No Rise in UOsm ... < 45% rise in UOsm ... Nephrogenic #Diabetes #Insipidus
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Diagnosis Algorithm UOsm ... ≥ POsm - Vasopressin-Dependent ... Cortisol deficiency UOsm ... < POsm - Vasopressin-independent
Hypernatremia Differential Diagnosis Algorithm - Diabetes Insipidus Workup Step #1 - Consider the history Step #2 - Assess
Algorithm - Diabetes Insipidus ... #2 - Assess the Uosm ... Sodium #nephrology #insipidus
Urine chemistry tests for the diagnostic evaluation of a patient with polyuria UOsm <100 mOsm/Kg (H2O diuresis)
with polyuria UOsm ... polydipsia • Diabetes insipidus ... 2 × (Na + K) = UOsm ... × (Na + K) << UOsm ... diagnosis #nephrology #Uosm
Diabetes Insipidus vs Syndrome of Inappropriate ADH (SIADH) - Comparison Table Diabetes Insipidus - Inadequate ADH SIADH -
Diabetes Insipidus ... Table Diabetes Insipidus ... #Diabetes #Insipidus ... Pathophysiology #Signs
Causes of Polyuria - Differential Diagnosis Algorithm Polyuria - Urine Output > 3L/day, Increased Urine Volume (>2ml/min) Osmotic
Loss - DDAVP -> Uosm ... Central Diabetes Insipidus ... - DDAVP -> Uosm ... Nephrogenic Diabetes Insipidus
Hypo-osmolar Hypotonic HypoNatremia Algorithm (Serum Na+ < 135 meq/L, serum Osm < 275 mosm/kg) Assess Volume Status,
135 meq/L, serum Osm ... < 275 mosm/kg) ... Urine Na, Urine Osm
Polyuria - Differential Diagnosis Algorithm Polyuria = >3L Urine output / 24 hours Urine osmolality = 2 (Na
osmolality > 300 mosm ... osmolality < 100 mosm ... kg • Diabetes Insipidus
Hyponatremia - Diagnostic Evaluation Algorithm Step 1: Consider whether Posm may actually be normal or elevated Step 2:
Consider whether Posm ... Step 2: Check Uosm
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