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Diagnosis and Management of Hypernatremia

#Hypernatremia #Differential #Algorithm #Causes #Nephrology #Diagnosis

** GrepMed Recommended Text: Nephrology Secrets -
of Hypernatremia ... #Hypernatremia ... #Differential #Algorithm ... #Causes #Nephrology ... #Diagnosis *
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... mmol/L - true hyponatremia ... • nephrotic syndrome ... renal failure #Hypernatremia ... #Algorithm #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Algorithm Syndrome ... Pain/Post-op • Neurologic ... osmole intake #Hyponatremia ... #Diagnosis #Algorithm
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Algorithm Syndrome ... Pain/Post-op • Neurologic ... osmole intake #Hyponatremia ... #Diagnosis #Algorithm
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... thecurbsiders #Hyponatremia ... #Algorithm #causes ... #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Hyponatremia: Hyperglycemia ... irrigants Hypotonic Hyponatremia ... Cirrhosis, Nephrotic syndrome ... #Algorithm #diagnosis
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... - Differential Diagnosis ... Cardiac failure #Hyponatremia ... #Algorithm #Causes ... #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Diagnosis Algorithm ... treat underlying cause ... UnremarkableLab #Hyponatremia ... #Algorithm #diagnosis
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Workup Algorithm ... Extrarenal Hypernatremia ... Ingestion Renal Hypernatremia ... MatthewHoMD #Hypernatremia
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... @NephroMD #hyponatremia ... #algorithm #causes ... #nephrology