33 results
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... • Osmotic diuresis ... Central diabetes insipidus ... Nephrogenic diabetes insipidus ... #nephrology #sodium
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... water loss, Serum Sodium ... administration • Osmotic diuresis ... kg • Diabetes Insipidus ... #Causes
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
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... 1) Check Urine ... • Hypovolemic: Diuretics ... Euvolemic: Diabetes insipidus ... #nephrology #sodium
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Salt Wasting vs SIADH ... Neurological event 2) Sodium ... ) Naturiesis → diuresis ... → Increased urine ... diagnosis #nephrology #hyponatremia
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
Hyponatremia Treatment Algorithm

CHF, Cirrhosis - Fluid restriction
SIADH - Fluid restriction
 - Consider salt tablets if etiology
Hyponatremia Treatment ... Algorithm CHF ... Fluid restriction SIADH ... -> free water diuresis ... #Treatment #Algorithm
Polyuria - Differential Diagnosis Algorithm
Urine Output > 3L /day
Water Diuresis (Urine Osm <100 mOsm/kg)
 • Primary
Differential Diagnosis Algorithm ... Central Diabetes Insipidus ... Nephrogenic Diabetes Insipidus ... Differential #Diagnosis #Algorithm ... #causes #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... OFF (UNa > 30): SIADH ... , Medications (diuretics ... #Algorithm #diagnosis ... #sodium #nephrology
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