22 results
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
to Hyponatremia ... uric acid <4 • SIADH ... #Hyponatremia # ... algorithm #diagnosis ... #sodium #low #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Repeat the sodium ... EUVOLEMIC • SIADH ... HYPERVOLEMIC • CHF ... Diagnosis #Workup #Algorithm ... #Nephrology
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... in addition) of volume ... - Urine sodium ... #Differential #Algorithm ... #Diagnosis #Nephrology
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Salt Wasting vs SIADH ... Neurological event 2) Sodium ... → Increased urine ... Pathophysiology #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 - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... underlying cause (CHF ... , SSRIs) - SIADH ... #diagnosis #nephrology ... #sodium
Hyponatremia Treatment Algorithm

CHF, Cirrhosis - Fluid restriction
SIADH - Fluid restriction
 - Consider salt tablets if etiology
Hyponatremia Treatment ... Algorithm CHF ... Fluid restriction SIADH ... indicated Any form of volume ... #Treatment #Algorithm
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
algorithm Urine ... restriction alone in SIADH ... Present (Uosm ≥100): SIADH ... , Renal Sodium loss ... #nephrology
Flowchart to diuretic use in acute heart failure.

(A) Congestion with volume overload. 

(B) Treatment algorithm after
volume overload ... (B) Treatment algorithm ... intravenous; SGLT2‐I, sodium–glucose ... ultrafiltration; UO, urine ... #Algorithm #Congestive
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... OFF (UNa > 30): SIADH ... polydipsia, Low solute ... #Algorithm #diagnosis ... #sodium #nephrology