11 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Diagnosis and Workup ... Repeat the sodium ... EUVOLEMIC • SIADH ... • nephrotic syndrome ... #Algorithm #Nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
uric acid <4 • SIADH ... Cirrhosis, Nephrotic syndrome ... #Hyponatremia #algorithm ... #diagnosis #sodium ... #low #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
algorithm Urine ... , Renal Sodium loss ... Cirrhosis, Nephrotic syndrome ... differential #diagnosis #table ... #sodium #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hypovolemic - Give volume ... cirrhosis, nephrotic syndrome ... , SSRIs) - SIADH ... #diagnosis #nephrology ... #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... Algorithm 1) ... mechanism 2) Volume ... #Algorithm #nephrology ... #sodium
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Cirrhosis, Nephrotic syndrome ... OFF (UNa > 30): SIADH ... polydipsia, Low solute ... #diagnosis #sodium ... #nephrology
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... administered • Can cause volume ... overload Urea powder ... promoting passive sodium ... #nephrology #treatment
SIADH Treatment Options
1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
This can cause volume ... Urea powder • Induces ... promoting passive sodium ... #Management #hyponatremia ... #nephrology #treatment
Management of Hyponatremia
Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125
Give
Management of Hyponatremia ... Normalizes in SIADH ... • IF SIADH — ... #algorithm #treatment ... #sodium
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
3 questions to work ... Assess volume status ... demyelination syndrome ... Diagnosis #Treatment #management ... #nephrology #sodium