17 results
Algorithm for Management of SIADH with Fluid Restriction and Urea

by Helbert Rondon, MD @NephroMD

#SIADH #Management #algorithm
Algorithm for Management ... of SIADH with Fluid ... Restriction and Urea ... #treatment #urea ... #nephrology
Gitelman Syndrome Pathophysiology
Gitelman Syndrome is a rare autosomal recessive salt-losing tubulopathy with a prevalence of 1-
Gitelman Syndrome ... Gitelman Syndrome ... thiazide-sensitive sodium-chloride ... #Syndrome #Pathophysiology ... #nephrology #diagnosis
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Differential Diagnosis Algorithm ... ADH promotes Urea ... Osmolarity 3) Urine Sodium ... Low Uric Acid → SIADH ... #nephrology #sodium
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia Algorithm ... Cirrhosis, Nephrotic syndrome ... OFF (UNa > 30): SIADH ... #diagnosis #sodium ... #nephrology
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... volume overload Urea ... promoting passive sodium ... #hyponatremia #nephrology ... #treatment
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Differential Diagnosis Algorithm ... cirrhosis, nephrotic syndrome ... , SSRIs) - SIADH ... #diagnosis #nephrology ... #sodium
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
SIADH Treatment Options
1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... Urea powder • Induces ... promoting passive sodium ... #hyponatremia #nephrology ... #treatment
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Repeat the sodium ... EUVOLEMIC • SIADH ... • nephrotic syndrome ... Diagnosis #Workup #Algorithm ... #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 ... Rhabdomyolysis Treatment ... #nephrology #management ... #pathophysiology