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nephrology differential low causes hypernatremia management table workup adh cancer cerebral chf clinical criticalcare foamed heartfailure hypotonic icu lazy oncology
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Neurological event 2) Sodium ... → Increased urine ... Pathophysiology #diagnosis ... #nephrology #hyponatremia ... #comparison
True Hyponatremia Differential Algorithm Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... acid high in hypovolemic ... - Urine sodium ... #Differential #Algorithm ... #Diagnosis #Nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Osmolarity 2) Urine ... Sodium 4) Serum ... Low Uric Acid → SIADH
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Based Approach to Hyponatremia ... Hypovolemic, Serum ... uric acid <4 • SIADH ... #algorithm #diagnosis ... #sodium #low #nephrology
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 ... , Renal Sodium loss ... #differential #diagnosis ... #table #sodium
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Algorithm Hypertonic ... ON (UNa < 30): Hypovolemia ... OFF (UNa > 30): SIADH ... #Algorithm #diagnosis ... #sodium #nephrology
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... Appropriate (↓ EABV ... ) - Consider: Hypovolemia ... Inappropriate - Consider: SIADH
Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... HYPOVOLEMIC • ... EUVOLEMIC • SIADH ... #Algorithm #Nephrology
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... Hypovolemic - Give ... , SSRIs) - SIADH ... #Algorithm #diagnosis ... #nephrology #sodium
Hyponatremia - Differential Algorithm Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP Hypotonic Hyponatremia: • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... : • Hypovolemia ... • Euvolemia: SIADH ... #diagnosis #causes ... #nephrology #sodium
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