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diagnosis nephrology differential causes table adh cancer cerebral chf clinical criticalcare foamed heartfailure hypernatremia hypotonic icu management oncology osmolality pathophysiology
True Hyponatremia Differential Algorithm Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... sodium low, uric ... acid high in hypovolemic ... - Urine sodium ... and uric acid low
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
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Sodium 4) Serum ... Uric Acid → SIADH ... #low #uricacid
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
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 ... can be high or low ... , Hypervolemia with
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 ... Primary polydipsia, Low ... #sodium #nephrology
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Algorithm UOsm ... Appropriate (↓ EABV ... ) - Consider: Hypovolemia ... Inappropriate - Consider: SIADH ... Primary polydipsia, Low
Hyponatremia - Differential Algorithm Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP Hypotonic Hyponatremia: • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... : • Hypovolemia ... • Euvolemia: SIADH ... causes #nephrology #sodium ... #low
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... 1) Check Urine ... : • Hypovolemic ... • Euvolemic (Low ... #nephrology #sodium
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
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