15 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Repeat the sodium ... volume loss - diuretics ... EUVOLEMIC • SIADH ... HYPERVOLEMIC • CHF ... #Nephrology
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 ... , Renal Sodium loss ... #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... (CHF, cirrhosis ... , SSRIs) - SIADH ... #diagnosis #nephrology ... #sodium
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... water loss, Serum Sodium ... administration • Osmotic diuresis ... #Nephrology #Differential ... #Causes
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
• Hypovolemia: Diuretics ... • Euvolemia: SIADH ... Alcohol MH/CCF ... #diagnosis #causes ... #nephrology #sodium
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... especially thiazide diuretics ... Reduced GFR, AKI/CRF ... Hypo-osmolar urine ... #Nephrology #Differential
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... especially thiazide diuretics ... Reduced GFR, AKI/CRF ... Hypo-osmolar urine ... #Nephrology #Differential
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... promoting passive sodium ... Saline: • If Urine ... #Management #hyponatremia ... #nephrology #treatment
SIADH Treatment Options
1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... promoting passive sodium ... 0.9% NS • If Urine ... #Management #hyponatremia ... #nephrology #treatment
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
usually caused by ... Measure urine osmolality ... include vaptans (HF ... #management #nephrology ... #sodium