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diagnosis differential management treatment causes hypernatremia low 2 3 cancer cerebral comparison di evaluation hypotonic insipidus oncology pathophysiology physiologic primary
Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
1 . ... Repeat the sodium ... EUVOLEMIC • SIADH ... HYPERVOLEMIC • CHF ... #Algorithm #Nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... water retention 1) ... Low Uric Acid → SIADH ... #nephrology #sodium
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Based Approach to Hyponatremia ... uric acid <4 • SIADH ... deficiency, Primary polydipsia ... #algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
underlying cause (CHF ... - Primary Polydipsia ... , SSRIs) - SIADH ... #diagnosis #nephrology ... #sodium
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Algorithm Hypertonic ... OFF (UNa > 30): SIADH ... 100): Primary polydipsia ... #Algorithm #diagnosis ... #sodium #nephrology
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Pathophysiology 1) ... Neurological event 2) Sodium ... → Increased urine ... Pathophysiology #diagnosis #nephrology ... #hyponatremia #
Hyponatremia Treatment Algorithm CHF, Cirrhosis - Fluid restriction SIADH - Fluid restriction - Consider salt tablets if etiology
Hyponatremia Treatment ... Algorithm CHF ... Fluid restriction SIADH ... water diuresis) 1° ... polydipsia - Normalize
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 ... Na >1 is predictive ... intake (Primary polydipsia ... #nephrology
Hyponatremia - Diagnostic Evaluation Algorithm Step 1: Consider whether Posm may actually be normal or elevated Step 2:
Evaluation Algorithm ... Step 1: Consider ... Check Uosm and/or Urine ... tests Step 5: If SIADH ... #Diagnosis #Workup
Hyponatremia - Differential Algorithm Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP Hypotonic Hyponatremia: • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
• Euvolemia: SIADH ... Potomania, Psychogenic polydipsia ... Alcohol MH/CCF ... diagnosis #causes #nephrology ... #sodium #low
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