7 results
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... Urologic irrigants Hypotonic ... OFF (UNa > 30): SIADH ... Reset osmostat, Cerebral ... #sodium #nephrology
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Cerebral Salt Wasting ... vs SIADH - Pathophysiology ... Neurological event 2) Sodium ... → Increased urine ... diagnosis #nephrology #hyponatremia
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 ... , Renal Sodium loss ... Insufficiency, Cerebral ... : Hypovolemia, Hypervolemia
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Renal losses, Cerebral ... uric acid <4 • SIADH ... #algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... , Recent TURP Hypotonic ... • Euvolemia: SIADH ... polydipsia • Hypervolemia ... causes #nephrology #sodium
A lazy man's classification of hyponatremia
There are two possible approaches to the diagnosis of hyponatremia: .
serum osmolality, urine ... osmolality and urinary sodium ... the patient has SIADH ... or cerebral salt ... #Algorithm #Differential
Management of Hyponatremia
Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125
Give
Management of Hyponatremia ... Normalizes in SIADH ... • IF SIADH — ... #Management #algorithm ... #treatment #sodium