93 results
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
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... sodium and serum ... sodium low, uric ... - Urine sodium ... #Differential #Algorithm
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... uric acid <4 • SIADH ... SatyaPatelMD #Volume #Hyponatremia ... #algorithm #diagnosis ... #sodium #low #nephrology
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 ... #SaltWasting #SIADH ... diagnosis #nephrology #hyponatremia
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... promoting passive sodium ... Saline: • If Urine ... #Management #hyponatremia ... #nephrology #treatment
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Diagnosis Algorithm ... treat underlying cause ... , SSRIs) - SIADH ... diagnosis #nephrology #sodium
Hyponatremia - Diagnostic Evaluation Algorithm

Step 1: Consider whether Posm may actually be normal or elevated
Step 2:
Hyponatremia - Diagnostic ... Evaluation Algorithm ... Check Uosm and/or Urine ... tests Step 5: If SIADH ... considered likely, the cause
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic ... OFF (UNa > 30): SIADH ... #Algorithm #diagnosis ... #sodium #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... normal volume-based algorithm ... Urine Na+K / serum ... restriction alone in SIADH ... , Renal Sodium loss
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... mmol/L - true hyponatremia ... EUVOLEMIC • SIADH ... Diagnosis #Workup #Algorithm