18 results
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... failure, Cirrhosis, Nephrotic ... syndrome) • ADH ... differential #diagnosis #table ... #sodium #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... losses, Diuretic ... and metabolic alkalosis ... , UNa < 20 • Nephrotic ... #Causes #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
GI losses • Renal ... especially thiazide diuretics ... Cirrhosis • Nephrotic ... GFR, AKI/CRF Hormonal ... #Nephrology #Differential
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
GI losses • Renal ... especially thiazide diuretics ... Cirrhosis • Nephrotic ... GFR, AKI/CRF Hormonal ... #Nephrology #Differential
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted 2° hyperaldosteronism
 • Low Urine Cl-: Vomiting, NGT
Primary Metabolic Alkalosis ... Cl intake, Diuretics ... High Urine Cl-: Diuretics ... hyperaldosteronism • High PRA: Renal ... #nephrology
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted - 2° hyperaldosteronism
 • Low Urine Cl-: Vomiting,
Primary Metabolic Alkalosis ... Cl intake, Diuretics ... High Urine Cl-: Diuretics ... hyperaldosteronism • High PRA: Renal ... #Nephrology #Causes
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
volume loss - diuretics ... liver failure • nephrotic ... syndromerenal ... Diagnosis #Workup #Algorithm ... #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
failure, Cirrhosis, Nephrotic ... syndrome - ... , Medications (diuretics ... Primary polydipsia, Low ... #sodium #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... mOsm/kg - Implies renal ... • Euvolemic (Low ... , Cushing syndrome ... #nephrology #sodium
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Diagnosis Algorithm ... Beer Potomania - Low ... liver failure, nephrotic ... syndrome ... #causes #nephrology