11 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
and Workup Step ... Repeat the sodium ... EUVOLEMIC • SIADH ... HYPERVOLEMIC • CHF ... #Algorithm #Nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Volume Based Approach ... to Hyponatremia ... uric acid <4 • SIADH ... algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hypovolemic - Give volume ... underlying cause (CHF ... , SSRIs) - SIADH ... #diagnosis #nephrology ... #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Algorithm 1) ... Check Urine Osmolality ... mechanism 2) Volume ... #Algorithm #nephrology ... #sodium
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
algorithm Urine ... poor response to volume ... restriction alone in 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 ... ultrafiltration; UO, urine ... Diuretic #Diuresis #CHF ... #Algorithm #Congestive
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
• Euvolemia: SIADH ... Hypervolemia: Congestive ... Alcohol MH/CCF ... diagnosis #causes #nephrology ... #sodium #low
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 SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
administered • Can cause volume ... promoting passive sodium ... Saline: • If Urine ... #Management #hyponatremia ... #nephrology #treatment
SIADH Treatment Options
1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... This can cause volume ... promoting passive sodium ... #Management #hyponatremia ... #nephrology #treatment