19 results
Classification, Differential Diagnosis, and Features of Hyponatremia According to Volume Status 

Hypervolemic hypernatremia 
 - CHF
- CHF - Cirrhosis ... - Drugs - SIADH ... Renal hypovolemic ... - Diuretics ... Diagnosis #Table #Causes
Flowchart to diuretic use in acute heart failure.

(A) Congestion with volume overload. 

(B) Treatment algorithm after
(B) Treatment algorithm ... intravenous; SGLT2‐I, sodium–glucose ... ultrafiltration; UO, urine ... #Diuretic #Diuresis ... #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 ... (diuretics, mineralocorticoid ... deficiency, Post-AKI diuresis ... (AKI, Post-AKI diuresis
Hyponatremia Treatment Algorithm

CHF, Cirrhosis - Fluid restriction
SIADH - Fluid restriction
 - Consider salt tablets if etiology
Hyponatremia Treatment ... Algorithm CHF ... consider adding loop diuretic ... -> free water diuresis ... #Treatment #Algorithm
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Salt Wasting vs SIADH ... Neurological event 2) Sodium ... ) Naturiesis → diuresis ... → Increased urine ... diagnosis #nephrology #hyponatremia
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Repeat the sodium ... HYPOVOLEMIC • ... volume loss - diuretics ... EUVOLEMIC • SIADH ... HYPERVOLEMIC • CHF
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
: Diuretics/Nephropathies ... • Euvolemia: SIADH ... Alcohol MH/CCF ... #diagnosis #causes ... #nephrology #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
1) Check Urine ... : • Hypovolemic ... : Diuretics, osmotic ... (solute) diuresis ... #nephrology #sodium
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... ON (UNa < 30): Hypovolemia ... OFF (UNa > 30): SIADH ... , Medications (diuretics ... #sodium #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Malignancy True hypovolemia ... especially thiazide diuretics ... Reduced GFR, AKI/CRF ... Hypo-osmolar urine