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diagnosis nephrology differential management sodium treatment workup acute cancer ebv edema evaluation generalized hypotonic hypovolemia injury kidney low oncology osmolality
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... normal volume-based algorithm ... Urine Na+K / serum ... restriction alone in SIADH ... Present (Uosm ≥100): SIADH
Causes of Hyponatremia - Differential Diagnosis Algorithm Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... • Reduced GFR, AKI ... Hypo-osmolar urine ... #Causes
Causes of Hyponatremia - Differential Diagnosis Algorithm Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... • Reduced GFR, AKI ... Hypo-osmolar urine ... #Causes
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Utilizing Uric Acid ADH ... Osmolarity 2) Urine ... Low Uric Acid → SIADH
Hyponatremia - Differential Diagnosis Algorithm ADH Independent: • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... ADH Independent ... insufficiency, SIADH ... #causes #nephrology
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Diagnosis Algorithm ... treat underlying cause ... • UOsm > 300 - ADH ... , SSRIs) - SIADH
Causes of Generalized Edema - Differential Diagnosis Algorithm Overfill (Increased renal sodium retention, Urine Na > 40meq/L)
Causes of Generalized ... sodium retention, Urine ... • NSAlDs • AKI ... Trauma #Edema #anasarca ... #Causes
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 ... considered likely, the cause
Hyponatremia (<135 mEq/L) is a common electrolyte abnormality caused by an excess of total body water
Hyponatremia (<135 ... electrolyte abnormality caused ... serum osmolality, urine ... #hyponatremia #ADH ... EBV #potomania #SIADH
Management of SIADH Treat underlying cause: • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... Saline: • If Urine ... antagonists: • Blocks ADH ... SatyaPatelMD #SIADH ... #Management #hyponatremia
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