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diagnosis differential metabolic hypernatremia workup chloride excretion hypokalemia hypotonic management medications metabolicalkalosis nongap pharmacology physiologic potassium rhabdomyolysis treatment urinary urine
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
Sodium loss (diuretics ... diuresis can be ... diuresis) RAAS ... syndrome) • ADH ... #sodium #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm Hypovolemia, UNa > 20: • Renal losses, Diuretic excess,
Causes of Hyponatremia ... losses, Diuretic ... and metabolic alkalosis ... Ketonuria, Osmotic diuresis ... #Causes #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... • Euvolemic (Low ... • Hypovolemic: Diuretics ... osmotic (solute) diuresis ... #nephrology #sodium
Causes of Hyponatremia - Differential Diagnosis Algorithm Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... GI losses • Renal ... especially thiazide diuretics ... Cirrhosis • Nephrotic ... GFR, AKI/CRF Hormonal
Causes of Hyponatremia - Differential Diagnosis Algorithm Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... GI losses • Renal ... especially thiazide diuretics ... Cirrhosis • Nephrotic ... GFR, AKI/CRF Hormonal
Diuretics and Agents Regulating Renal Excretion Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide) • Glaucoma • Epilepsy • Altitude
• Metabolic alkalosis ... syndrome • Hyponatremia ... Kidney stones caused ... #Diuresis #Nephrology ... #Medications #Table
Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Repeat the sodium ... volume loss - diuretics ... liver failure • nephrotic ... syndrome • 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
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
Hyponatremia - Differential Algorithm Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP Hypotonic Hyponatremia: • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
• Hypovolemia: Diuretics ... Syndrome, Chronic ... Renal Failure, ... #nephrology #sodium ... #low
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