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diagnosis differential management causes hypernatremia low workup cardiology cerebral comparison congestive diuresis gitelman heartfailure hypokalemia hypotonic in oncology physiologic polydipsia
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Neurological event 2) Sodium ... ) Naturiesis → diuresis ... → Increased urine ... #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
Hyponatremia Treatment Algorithm CHF, Cirrhosis - Fluid restriction SIADH - Fluid restriction - Consider salt tablets if etiology
Hyponatremia Treatment ... Algorithm CHF ... Fluid restriction SIADH ... -> free water diuresis ... #Treatment #Algorithm
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
Flowchart to diuretic use in acute heart failure. (A) Congestion with volume overload. (B) Treatment algorithm after
(B) Treatment algorithm ... blood pressure; HF ... intravenous; SGLT2‐I, sodium–glucose ... ultrafiltration; UO, urine ... #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 ... restriction alone in SIADH ... , Renal Sodium loss ... #nephrology
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Algorithm Hypertonic ... OFF (UNa > 30): SIADH ... , Medications (diuretics ... #Algorithm #diagnosis ... #sodium #nephrology
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Based Approach to Hyponatremia ... uric acid <4 • SIADH ... SatyaPatelMD #Volume #Hyponatremia ... #algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... underlying cause (CHF ... , SSRIs) - SIADH ... #diagnosis #nephrology ... #sodium
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
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