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Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
Syndrome Step ... /nephritic syndromes ... dysmorphic RBCs in urine ... #Syndrome #Comparison ... #Algorithm #Nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
failure, Cirrhosis, Nephrotic ... syndromeUrine ... #Hyponatremia #algorithm ... #diagnosis #sodium ... #low #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Syndrome of Inappropriate ... Malignancy True hypovolemia ... Cirrhosis • Nephrotic ... Hypo-osmolar urine ... #Hyponatremia #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Syndrome of Inappropriate ... Malignancy True hypovolemia ... Cirrhosis • Nephrotic ... Hypo-osmolar urine ... #Hyponatremia #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
ON (UNa < 30): Hypovolemia ... failure, Cirrhosis, Nephrotic ... syndrome - ... #diagnosis #sodium ... #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... Urine Na+K / serum ... failure, Cirrhosis, Nephrotic ... syndrome) • ADH ... #sodium #nephrology
Gitelman Syndrome Overview

What?
• Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter
• Gitelman's syndrome
thiazide-sensitive sodium ... thiazide-sensitive sodium ... Hypocalciuria (spot urine ... #diagnosis #nephrology ... #management #pathophysiology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Hyponatremia: • Hypovolemia ... Liver Cirrhosis, Nephrotic ... Syndrome, Chronic ... diagnosis #causes #nephrology ... #sodium #low