21 results
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Utilizing Uric Acid ADH ... Low Uric Acid → SIADH ... Rachel Stern MD #Hyponatremia
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Neurological event 2) Sodium ... Hypovolaemia → ADH ... → Increased urine ... diagnosis #nephrology #hyponatremia ... #comparison
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Hyponatremia: Hyperglycemia ... irrigants Hypotonic Hyponatremia ... OFF (UNa > 30): SIADH ... #sodium #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... mmol/L - true hyponatremia ... HYPERVOLEMIC • CHF ... renal failure #Hypernatremia
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... underlying cause (CHF ... , SSRIs) - SIADH ... UnremarkableLab #Hyponatremia ... diagnosis #nephrology #sodium
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Approach to Hypotonic Hyponatremia ... case of hypotonic hyponatremia ... normal volume-based algorithm ... Urine Na+K / serum ... Physiologic #Hypotonic #Hyponatremia
Hyponatremia Treatment Algorithm

CHF, Cirrhosis - Fluid restriction
SIADH - Fluid restriction
 - Consider salt tablets if etiology
Hyponatremia Treatment ... Algorithm CHF ... Fluid restriction SIADH ... status turns off ADH ... DrEricStrong #Hyponatremia
Hyponatremia - Diagnostic Evaluation Algorithm

Step 1: Consider whether Posm may actually be normal or elevated
Step 2:
Hyponatremia - Diagnostic ... Evaluation Algorithm ... Check Uosm and/or Urine ... tests Step 5: If SIADH ... DrEricStrong #Hyponatremia
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... uric acid <4 • SIADH ... SatyaPatelMD #Volume #Hyponatremia ... #algorithm #diagnosis ... #sodium #low #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... Reduced GFR, AKI/CRF ... Hypo-osmolar urine ... osmole intake #Hyponatremia