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Pathophysiology of hypotonic hyponatremia

by Helbert Rondon, MD @NephroMD

#hypotonic #hyponatremia #nephrology #algorithm #Pathophysiology
Pathophysiology ... of hypotonic hyponatremia ... #hyponatremia # ... nephrology #algorithm ... #Pathophysiology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic ... Hyponatremia: Hyperglycemia ... Hyponatremia: ... Cirrhosis, Nephrotic syndrome
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
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Extrarenal Hypernatremia ... Ingestion Renal Hypernatremia ... MatthewHoMD #Hypernatremia ... #Algorithm #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Hyponatremia - Differential ... Hyponatremia: Hyperlipidemia ... Hyponatremia: ... Cirrhosis, Nephrotic Syndrome ... Hyponatremia: Hyperglycemia
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Hyponatremia The ... hyponatremia, give ... normal volume-based algorithm ... Cirrhosis, Nephrotic syndrome ... #Hyponatremia #
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
Hyponatremia - Diagnosis ... and Treatment Hyponatremia ... 3 questions to work ... 1) Is it hypotonic ... Treatment of hyponatremia
Hyponatremia Differential Diagnosis Algorithm in Cancer
UOsm ≥ 100 mOsm/kg = Urine is inappropriately concentrated for hypotonic
Hyponatremia Differential ... Diagnosis Algorithm ... concentrated for hypotonic ... capillary leak syndrome ... metastases) #Hyponatremia
Guillain-Barre Syndrome - Summary

Acute AIDP that presents with rapidly progressive flaccid weakness

Epidemiology:
 • 1-2 cases/100,000 per
Guillain-Barre Syndrome ... Guillain-Barre Pathophysiology ... complete paralysis of all ... /constipation, hyponatremia ... management #treatment #neurology