42 results
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
water retention 1) ... Serum Osmolarity 2) ... 3) Urine Sodium ... Uric Acid → SIADH ... #nephrology #sodium
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... addition) of volume status ... sodium low, uric ... - Urine sodium ... #Diagnosis #Nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
uric acid <4 • SIADH ... Hypothyroidism, Low ... Cirrhosis, Nephrotic syndrome ... #algorithm #diagnosis ... #sodium #low #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Workup Step 1 ... Repeat the sodium ... Step 2. ... Assess volume status ... #Nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
1) Check Urine ... renal mechanism 2) ... Volume Status ... • Euvolemic (Low ... #nephrology #sodium
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Pathophysiology 1) ... Neurological event 2) ... Sodium loss from ... → Increased urine ... #hyponatremia #
Hyponatremia - Diagnostic Evaluation Algorithm

Step 1: Consider whether Posm may actually be normal or elevated
Step 2:
Step 1: Consider ... elevated Step 2: ... Check Uosm and/or Urine ... Assess volume status ... tests Step 5: If SIADH
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... Cirrhosis, Nephrotic syndrome ... OFF (UNa > 30): SIADH ... Primary polydipsia, Low ... #sodium #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 ... Na >1 is predictive ... Cirrhosis, Nephrotic syndrome ... #nephrology
Hyponatremia Diagnostic Algorithm
1) Check serum osmolality
2) Check urine osmolality
3) ADH Dependent - Check volume status, urine
Algorithm 1) Check ... serum osmolality 2) ... - Check volume status ... , urine sodium, ... #nephrology