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nephrology diagnosis differential management adh cancer causes cerebral hypotonic low oncology osmolality pathophysiology physiologic potomania raas saltwasting table thiazides volume
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 ... diagnosis #nephrology #hyponatremia ... #comparison
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Algorithm Hypertonic ... - RAAS ON (UNa ... < 30): Hypovolemia ... > 30): SIADH, Medications ... #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
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 ... or Ineffective (UNa ... , Renal Sodium loss ... solute intake, UNa
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
Hyponatremia (<135 mEq/L) is a common electrolyte abnormality caused by an excess of total body water
body water in comparison ... Measured urine sodium ... #RAAS #Hypovolemia ... #EBV #potomania ... #SIADH #Thiazides
SIADH Treatment Options 1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... promoting passive sodium ... 0.9% NS • If Urine ... osmolality < 538 AND UNa ... #Management #hyponatremia
Management of SIADH Treat underlying cause: • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
promoting passive sodium ... Saline: • If Urine ... osmolality < 538 AND UNa ... #Management #hyponatremia ... #nephrology #treatment
Hyponatremia Differential Diagnosis Algorithm in Cancer UOsm ≥ 100 mOsm/kg = Urine is inappropriately concentrated for hypotonic
Hyponatremia Differential ... Diagnosis Algorithm ... 100 mOsm/kg = Urine ... appropriate • Hypovolemia ... inappropriate • SIAD
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