24 results
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... water retention 1) ... Uric Acid → SIADH ... #nephrology #sodium
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
uric acid <4 • SIADH ... Hypothyroidism, Low ... Glucocorticoid deficiency, Primary ... #algorithm #diagnosis ... #sodium #low #nephrology
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... sodium low, uric ... - Urine sodium ... and uric acid low ... #Diagnosis #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... OFF (UNa > 30): SIADH ... (UOsm < 100): 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 ... water intake (Primary ... #nephrology
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Pathophysiology 1) ... Neurological event 2) Sodium ... → Increased urine ... Pathophysiology #diagnosis #nephrology ... #hyponatremia #
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Algorithm UOsm ... Inappropriate - Consider: SIADH ... Vasopressin-independent - Consider: Primary ... polydipsia, Low ... #causes #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Workup Step 1 ... Repeat the sodium ... EUVOLEMIC • SIADH ... Diagnosis #Workup #Algorithm ... #Nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... Solute Intake - Primary ... , SSRIs) - SIADH ... #diagnosis #nephrology ... #sodium
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
water loss, Serum Sodium ... 145 mmol/L High Urine ... mannitol, glucosuria Low ... Urine Osmolality ... #Nephrology #Differential