18 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 ... #Algorithm #Nephrology
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
Flowchart to diuretic use in acute heart failure.

(A) Congestion with volume overload. 

(B) Treatment algorithm after
use in acute heart ... (B) Treatment algorithm ... intravenous; SGLT2‐I, sodium–glucose ... ultrafiltration; UO, urine ... #CHF #Algorithm
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... Algorithm 1) ... Check Urine Osmolality ... • Hypovolemic: Diuretics ... #sodium
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 RAAS Inactive ... , Renal Sodium loss
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
A lazy man's classification of hyponatremia
There are two possible approaches to the diagnosis of hyponatremia: .
In their most basic ... serum osmolality, urine ... osmolality and urinary sodium ... the patient has SIADH ... #Algorithm #Differential
Hypertonic Saline for Treatment of Hyponatremic Encephalopathy
1) 100 ml bolus of 3% NaCl over 10 min.
Hypertonic Saline for Treatment ... of Hyponatremic ... Increase in sodium ... L. 5) Monitor urine ... of a free water diuresis
Management of Hyponatremia
Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125
Give
Management of Hyponatremia ... not improving in ... SIADH • IF SIADH ... #Management #algorithm ... #treatment #sodium
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