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diagnosis nephrology differential management hypernatremia causes heartfailure table workup adh cerebral clinical congestive criticalcare ebv foamed hypotonic hypovolemia icu in
Flowchart to diuretic use in acute heart failure. (A) Congestion with volume overload. (B) Treatment algorithm after
(B) Treatment algorithm ... ultrafiltration; UO, urine ... #Diuretic #Diuresis ... #CHF #Algorithm ... #HeartFailure #Cardiology
Hyponatremia Treatment Algorithm CHF, Cirrhosis - Fluid restriction SIADH - Fluid restriction - Consider salt tablets if etiology
Hyponatremia Treatment ... Algorithm CHF ... consider adding loop diuretic ... -> free water diuresis ... #Treatment #Algorithm
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 ... (diuretics, mineralocorticoid ... deficiency, Post-AKI diuresis ... (AKI, Post-AKI diuresis
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Neurological event 2) Sodium ... ) Naturiesis → diuresis ... → Increased urine ... diagnosis #nephrology #hyponatremia ... #comparison
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
1) Check Urine ... • Euvolemic (Low ... • Hypovolemic: Diuretics ... osmotic (solute) diuresis ... #nephrology #sodium
Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Repeat the sodium ... volume loss - diuretics ... EUVOLEMIC • SIADH ... HYPERVOLEMIC • CHF ... Diagnosis #Workup #Algorithm
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Algorithm Hypertonic ... OFF (UNa > 30): SIADH ... , Medications (diuretics ... Primary polydipsia, Low ... #sodium #nephrology
Causes of Hypernatremia - Differential Diagnosis Algorithm Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L High
water loss, Serum Sodium ... 145 mmol/L High Urine ... administration • Osmotic diuresis ... mannitol, glucosuria Low ... Urine Osmolality
Hyponatremia - Differential Algorithm Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP Hypotonic Hyponatremia: • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
• Hypovolemia: Diuretics ... • Euvolemia: SIADH ... Alcohol MH/CCF ... causes #nephrology #sodium ... #low
Management of Hyponatremia Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125 Give
Management of Hyponatremia ... Failure - Add Diuretics ... Add Diuretics, Consider ... #Management #algorithm ... #treatment #sodium
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