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diagnosis nephrology differential management hypernatremia table adh cardiology clinical criticalcare foamed heartfailure hyperkalemia hypotonic icu k oncology osmolality pharmacology physiologic
Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Repeat the sodium ... HYPOVOLEMIC • ... EUVOLEMIC • SIADH ... HYPERVOLEMIC • CHF ... #Algorithm #Nephrology
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Hypovolemic, Serum ... uric acid <4 • SIADH ... Hypothyroidism, Low ... #algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Appropriate (↓ EABV ... ) - Consider: Hypovolemia ... Inappropriate - Consider: SIADH ... Primary polydipsia, Low ... #causes #nephrology
Hyponatremia - Differential Algorithm Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP Hypotonic Hyponatremia: • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
• Euvolemia: SIADH ... Alcohol MH/CCF ... #diagnosis #causes ... #nephrology #sodium ... #low
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... Hypovolemic - Give ... (CHF, cirrhosis ... , SSRIs) - SIADH ... diagnosis #nephrology #sodium
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... normal volume-based algorithm ... Urine Na+K / serum ... , Renal Sodium loss ... can be high or low
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
Algorithm 1) ... Check Urine Osmolality ... : • Hypovolemic ... • Euvolemic (Low ... #sodium
Hyponatremia (<135 mEq/L) is a common electrolyte abnormality caused by an excess of total body water
hypervolemic, hypovolemic ... Measured urine sodium ... #RAAS #Hypovolemia ... #EBV #potomania ... #SIADH #Thiazides
Hyponatremia - Diagnosis and Treatment Hyponatremia is usually caused by the inability to excrete water normally.
3 questions to work ... Measure urine osmolality ... volume status (EABV ... include vaptans (HF ... management #nephrology #sodium
Hyponatremia Differential Diagnosis Algorithm in Cancer UOsm ≥ 100 mOsm/kg = Urine is inappropriately concentrated for hypotonic
Diagnosis Algorithm ... in Cancer UOsm ... 100 mOsm/kg = Urine ... appropriate • Hypovolemia ... inappropriate • SIAD
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