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Diagnosis and Management of Hypernatremia

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

** GrepMed Recommended Text: Nephrology Secrets -
Management of Hypernatremia ... #Hypernatremia ... #Differential #Algorithm ... #Causes #Nephrology ... Recommended Text: Nephrology
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 ... Diagnosis #Workup #Algorithm
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Syndrome of Inappropriate ... Pain/Post-op • Neurologic ... osmole intake #Hyponatremia ... #Causes
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Syndrome of Inappropriate ... Pain/Post-op • Neurologic ... osmole intake #Hyponatremia ... #Causes
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Tea and Toast Syndrome ... thecurbsiders #Hyponatremia ... #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 ... SatyaPatelMD #Hyponatremia
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... Cardiac failure #Hyponatremia ... Differential #Diagnosis #Algorithm ... #Causes #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Diagnosis Algorithm ... cirrhosis, nephrotic syndrome ... UnremarkableLab #Hyponatremia ... #diagnosis #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Extrarenal Hypernatremia ... Ingestion Renal Hypernatremia ... MatthewHoMD #Hypernatremia ... #nephrology #sodium
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... Hypernatremia ... Hyperventilation #Hypernatremia ... #Nephrology #Differential ... #Causes