13 results
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... : • ADH ON (UOsm ... > 100): - RAAS ... OFF (UNa > 30): SIADH ... #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 ... RAAS Inactive ... , Renal Sodium loss
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Utilizing Uric Acid ADH ... Sodium 4) Serum ... Low Uric Acid → SIADH
Hyponatremia (<135 mEq/L) is a common electrolyte abnormality caused by an excess of total body water
among the possible causes ... in blood urea causes ... Measured urine sodium ... #hyponatremia #ADH ... EBV #potomania #SIADH
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:
Evaluation Algorithm ... Check Uosm and/or Urine ... tests Step 5: If SIADH ... considered likely, the cause ... #Diagnosis #Workup
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
, ADH (appropriately ... 3 questions to work ... 2) Is ADH elevated ... Measure urine osmolality ... management #nephrology #sodium
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
promoting passive sodium ... Saline: • If Urine ... antagonists: • Blocks ADH ... #Management #hyponatremia ... #nephrology #treatment
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 ... vaptans) • Blocks ADH ... #Management #hyponatremia
Primary Polydipsia
Definition: Excessive volitional water intake
Epidemiology:
 • 6-20% of patients with psychiatric disorders - Most commonly
ADH suppression ... with suppressed ADH ... Pseudohyponatremia, SIADH ... intoxication Initial Workup ... , Urine Sodium