15 results
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
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
(CHF, cirrhosis ... - Primary Polydipsia ... , SSRIs) - SIADH ... #diagnosis #nephrology ... #sodium
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
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 - 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
Hyponatremia - Diagnostic Evaluation Algorithm

Step 1: Consider whether Posm may actually be normal or elevated
Step 2:
Step 1: Consider ... Check Uosm and/or Urine ... tests Step 5: If SIADH ... considered likely, the cause ... #Diagnosis #Workup
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Reduced GFR, AKI/CRF ... Hypo-osmolar urine ... suppression • Primary polydipsia ... #Nephrology #Differential
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Reduced GFR, AKI/CRF ... Hypo-osmolar urine ... suppression • Primary polydipsia ... #Nephrology #Differential
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... Algorithm 1) ... Check Urine Osmolality ... #Algorithm #nephrology ... #sodium