22 results
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
algorithm Urine ... restriction alone ... in SIADH RAAS ... : Hypovolemia, Hypervolemia ... #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... Urologic irrigants Hypotonic ... OFF (UNa > 30): SIADH ... polydipsia, Low solute ... #sodium #nephrology
Hypo-osmolar Hypotonic HypoNatremia Algorithm (Serum Na+ < 135 meq/L, serum Osm < 275 mosm/kg)
Assess Volume Status,
Hypo-osmolar Hypotonic ... HypoNatremia Algorithm ... mosm/kg) Assess Volume ... #Nephrology #Differential ... #Hypotonic
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
to Hyponatremia ... uric acid <4 • SIADH ... #Hyponatremia # ... algorithm #diagnosis ... #sodium #low #nephrology
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... in addition) of volume ... - Urine sodium ... #Differential #Algorithm ... #Diagnosis #Nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... • Euvolemia: SIADH ... polydipsia • Hypervolemia ... diagnosis #causes #nephrology ... #sodium #low
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Salt Wasting vs SIADH ... Neurological event 2) Sodium ... → Increased urine ... Pathophysiology #diagnosis #nephrology ... #hyponatremia #
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Sodium 4) Serum ... Low Uric Acid → SIADH ... #nephrology #sodium
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... EUVOLEMIC • SIADH ... Diagnosis #Workup #Algorithm ... #Nephrology
Management of Hyponatremia
Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125
Give
Management of Hyponatremia ... Hypertonic Saline ... • IF SIADH — ... #Management #algorithm ... #treatment #sodium