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diagnosis differential management hypernatremia causes pathophysiology adh chloride ebv gitelman hypokalemia hypotonic hypovolemia lazy metabolic osmolality physiologic potomania raas saltwasting
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Neurological event 2) Sodium ... → Increased urine ... Pathophysiology #diagnosis #nephrology ... #hyponatremia # ... comparison
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Renal losses, Cerebral ... uric acid <4 • SIADH ... Hypothyroidism, Low ... #algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Sodium 4) Serum ... Uric Acid → SIADH ... #nephrology #sodium
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 ... Reset osmostat, Cerebral ... 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 ... can be high or low ... Insufficiency, Cerebral ... #nephrology
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
A lazy man's classification of hyponatremia There are two possible approaches to the diagnosis of hyponatremia: .
serum osmolality, urine ... osmolality and urinary sodium ... the patient has SIADH ... or cerebral salt ... #Algorithm #Differential
Metabolic Alkalosis - Urinary Chloride Algorithm Cl- responsive metabolic alkalosis • Kidney loss of Cl-
Urinary Chloride Algorithm ... • Normal/low ... sodium is typically ... the excretion of sodium ... #Algorithm #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... 1) Check Urine ... • Euvolemic (Low ... Diagnosis #Workup #Algorithm ... #nephrology #sodium
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