24 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
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Pathophysiology 1) ... Neurological event 2) ... Sodium loss from ... Hypovolaemia → ADH ... #hyponatremia #
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
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
Hyponatremia Diagnostic Algorithm
1) Check serum osmolality
2) Check urine osmolality
3) ADH Dependent - Check volume status, urine
Algorithm 1) Check ... serum osmolality 2) ... 3) ADH Dependent ... , urine sodium, ... #nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Diagnosis Algorithm ... ADH Independent ... Beer Potomania - Low ... insufficiency, SIADH ... #causes #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
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... cirrhosis, nephrotic syndrome ... , SSRIs) - SIADH ... #diagnosis #nephrology ... #sodium
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
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
1) Is it hypotonic ... 2) Is ADH elevated ... Measure urine osmolality ... demyelination syndrome ... #sodium