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Flowchart to diuretic use in acute heart failure.

(A) Congestion with volume overload. 

(B) Treatment algorithm after
(A) Congestion with ... (B) Treatment algorithm ... intravenous; SGLT2‐I, sodium–glucose ... ultrafiltration; UO, urine ... #CHF #Algorithm
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 ... : SIADH, Renal Sodium ... can be high or low ... differential #diagnosis #table
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... 1) Check Urine ... • Euvolemic (Low ... • Hypovolemic: Diuretics ... #nephrology #sodium
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... • Drugs • Pulmonary ... especially thiazide diuretics ... With edema • Congestive ... Hypo-osmolar urine
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... • Drugs • Pulmonary ... especially thiazide diuretics ... With edema • Congestive ... Hypo-osmolar urine
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
water loss, Serum Sodium ... 145 mmol/L High Urine ... administration • Osmotic diuresis ... mannitol, glucosuria Low ... Urine Osmolality
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
Torsemide) • Acute pulmonary ... nephrotic syndrome • Hyponatremia ... Tolvaptan) • Treatment ... and euvolemic hyponatremia ... #Medications #Table
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... • Hypovolemia: Diuretics ... Hypervolemia: Congestive ... causes #nephrology #sodium ... #low
It is important to recognize Acute Decompensated Heart Failure (ADHF) as more than just simply a
mental status and low ... urine output. ... with presence of pulmonary ... excreted using diuretics ... #table #foamed