16 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 - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Diagnosis Algorithm ... water retention 1) ... Osmolarity 3) Urine ... Low Uric Acid → SIADH ... #nephrology #sodium
Hypernatremia Differential Diagnosis Algorithm - Diabetes Insipidus Workup

Step #1 - Consider the history
Step #2 - Assess
Diabetes Insipidus Workup ... Step #1 - Consider ... Uglucose Step #3 ... #Sodium #nephrology ... #insipidus #DI
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
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Pathophysiology 1) ... Neurological event 2) Sodium ... from tubules 3) ... → Increased urine ... #hyponatremia #
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
Hypernatremia - Diagnostic Evaluation Algorithm
Step 1: Consider history. Most patients presenting with hypernatremia are either very
Step 1: Consider ... Check Uosm Step 3: ... If patient has DI ... #Diagnosis #Workup ... #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 ... Gravity Step 3: ... tests Step 5: If SIADH ... #Diagnosis #Workup
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 #low