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diagnosis nephrology differential management causes hypernatremia cardiology heartfailure table workup adh cerebral clinical comparison congestive criticalcare ebv foamed hyperkalemia hypotonic
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
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
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
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Algorithm Hypertonic ... Urologic irrigants Hypotonic ... OFF (UNa > 30): SIADH ... , Medications (diuretics ... #sodium #nephrology
Hyponatremia - Differential Algorithm Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP Hypotonic Hyponatremia: • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... • Hypovolemia: Diuretics ... • Euvolemia: SIADH ... Alcohol MH/CCF ... causes #nephrology #sodium
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 ... volume loss - diuretics ... EUVOLEMIC • SIADH ... HYPERVOLEMIC • CHF ... Diagnosis #Workup #Algorithm
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 ... 300 mmol/kg • Hypertonic ... administration • Osmotic diuresis ... glucosuria Low Urine
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... 1) Check Urine ... • Hypovolemic: Diuretics ... osmotic (solute) diuresis ... #nephrology #sodium
Hypertonic Saline for Treatment of Hyponatremic Encephalopathy 1) 100 ml bolus of 3% NaCl over 10 min.
Hypertonic Saline ... for Treatment of ... Hyponatremic Encephalopathy ... L. 5) Monitor urine ... of a free water diuresis
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