10 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
1 . ... Repeat the sodium ... EUVOLEMIC • SIADH ... • psychogenic polydipsia ... #Algorithm #Nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... water retention 1) ... Low Uric Acid → SIADH ... #nephrology #sodium
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... uric acid <4 • SIADH ... deficiency, Primary polydipsia ... #algorithm #diagnosis ... #sodium #low #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 ... intake (Primary polydipsia ... #sodium #nephrology
Primary Polydipsia
Definition: Excessive volitional water intake
Epidemiology:
 • 6-20% of patients with psychiatric disorders - Most commonly
Pseudohyponatremia, SIADH ... intoxication Initial Workup ... Osm, Serum Sodium ... , Urine Sodium ... diagnosis #management #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... Algorithm 1) ... Check Urine Osmolality ... #Algorithm #nephrology ... #sodium
SIADH Treatment Options
1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... Options 1. ... promoting passive sodium ... #Management #hyponatremia ... #nephrology #treatment
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
restriction: • Restrict 1 ... promoting passive sodium ... Saline: • If Urine ... #Management #hyponatremia ... #nephrology #treatment
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
3 questions to work ... 1) Is it hypotonic ... Measure urine osmolality ... #management #nephrology ... #sodium
Hyponatremia Differential Diagnosis Algorithm in Cancer
UOsm ≥ 100 mOsm/kg = Urine is inappropriately concentrated for hypotonic
in Cancer UOsm ... 100 mOsm/kg = Urine ... inappropriate • SIAD ... adrenalitis; PD-1 ... #algorithm #nephrology