27 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... and Workup Step ... mmol/L - true hyponatremia ... • nephrotic syndrome ... renal failure #Hypernatremia
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic Hyponatremia ... ON (UNa < 30): Hypovolemia ... Cirrhosis, Nephrotic syndrome ... Primary polydipsia, Low
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Extrarenal Hypernatremia ... • Euvolemic (Low ... Ingestion Renal Hypernatremia ... MatthewHoMD #Hypernatremia
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... EABV) - Consider: Hypovolemia ... Primary polydipsia, Low ... @NephroMD #hyponatremia ... algorithm #causes #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Diagnosis Algorithm Syndrome ... Pain/Post-op • Neurologic ... Malignancy True hypovolemia ... osmole intake #Hyponatremia
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Diagnosis Algorithm Syndrome ... Pain/Post-op • Neurologic ... Malignancy True hypovolemia ... osmole intake #Hyponatremia
Cancer agents and Electrolyte Disorders
 • Hypocalcemia: Cisplatin from Low Mg, Cetuximab- due to low Mg
Axitinib,
Disorders • Hypocalcemia ... Ifosfamide - Fanconi syndrome ... Trastuzumab • Hyponatremia ... Trastuzumab • Hypokalemia ... Ifosfamide - Fanconi syndrome
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... Diagnosis Algorithm Hypovolemia ... Hypovolemia, UNa ... Cardiac failure #Hyponatremia ... Algorithm #Causes #nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Tea and Toast Syndrome ... Beer Potomania - Low ... thecurbsiders #Hyponatremia ... Algorithm #causes #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Hypothyroidism, Low ... Cirrhosis, Nephrotic syndrome ... SatyaPatelMD #Volume #Hyponatremia ... #nephrology