13 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
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... Algorithm 1) ... Check Urine Osmolality ... #Algorithm #nephrology ... #sodium
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
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 ... , Renal Sodium loss ... #nephrology
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 #low
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
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
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
3 questions to work ... Measure urine osmolality ... include vaptans (HF ... #management #nephrology ... #sodium
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
Primary Polydipsia
Definition: Excessive volitional water intake
Epidemiology:
 • 6-20% of patients with psychiatric disorders - Most commonly
occurs in only ... Pseudohyponatremia, SIADH ... intoxication Initial Workup ... , Urine Sodium ... diagnosis #management #nephrology