14 results
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... ADH promotes Urea ... water retention 1) ... #nephrology #sodium
Gitelman Syndrome Pathophysiology
Gitelman Syndrome is a rare autosomal recessive salt-losing tubulopathy with a prevalence of 1-
Gitelman Syndrome ... Gitelman Syndrome ... prevalence of 1- ... #Syndrome #Pathophysiology ... #nephrology #diagnosis
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... 1) Check Urine ... • Euvolemic (Low ... , Cushing syndrome ... #nephrology #sodium
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted 2° hyperaldosteronism
 • Low Urine Cl-: Vomiting, NGT
Differential Diagnosis Algorithm ... , Gitelman Syndrome ... Volume Expanded 1° ... Differential #Diagnosis #Algorithm ... #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Workup Step 1 ... Repeat the sodium ... • nephrotic syndrome ... Diagnosis #Workup #Algorithm ... #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... Cirrhosis, Nephrotic syndrome ... Primary polydipsia, Low ... #Algorithm #diagnosis ... #sodium #nephrology
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted - 2° hyperaldosteronism
 • Low Urine Cl-: Vomiting,
Differential Diagnosis Algorithm ... , Gitelman Syndrome ... Volume Expanded - 1° ... Differential #Diagnosis #Algorithm ... #Nephrology #Causes
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Hypothyroidism, Low ... Cirrhosis, Nephrotic syndrome ... #algorithm #diagnosis ... #sodium #low #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... +K / serum Na >1 ... can be high or low ... Cirrhosis, Nephrotic syndrome ... #nephrology
Gitelman Syndrome Overview

What?
• Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter
• Gitelman's syndrome
Gitelman Syndrome ... thiazide-sensitive sodium ... alkalosis • Normal or low ... #nephrology #management ... #pathophysiology