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nephrology diagnosis differential management hypernatremia hypotonic lazy low physiologic polydipsia table volume
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 •
Based Approach to Hyponatremia ... uric acid <4 • SIADH ... Glucocorticoid deficiency, Primary ... #algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... underlying cause (CHF ... Solute Intake - Primary ... , SSRIs) - SIADH ... diagnosis #nephrology #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 ... , Renal Sodium loss ... water intake (Primary
Primary Polydipsia Definition: Excessive volitional water intake Epidemiology: • 6-20% of patients with psychiatric disorders - Most commonly
hypothalamic thirst center ... Pseudohyponatremia, SIADH ... intoxication Initial Workup ... Osm, Serum Sodium ... , Urine Sodium
A lazy man's classification of hyponatremia There are two possible approaches to the diagnosis of hyponatremia: .
serum osmolality, urine ... osmolality and urinary ... sodium). ... the patient has SIADH ... #Algorithm #Differential
SIADH Treatment Options 1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... : Pain, Primary ... promoting passive sodium ... 0.9% NS • If Urine ... #Management #hyponatremia
Management of SIADH Treat underlying cause: • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
include pain, primary ... 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 ... Treatment: Treatment ... include vaptans (HF ... management #nephrology #sodium
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