10 results
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... Sodium loss (diuretics ... failure, Cirrhosis, Nephrotic ... syndrome) • ADH ... #sodium #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Euvolemic; no physiologic ... 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
Euvolemic; no physiologic ... GI losses • Renal ... especially thiazide diuretics ... Cirrhosis • Nephrotic ... GFR, AKI/CRF Hormonal
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
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 ... syndromerenal ... #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
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Hypothyroidism, Low ... failure, Cirrhosis, Nephrotic ... syndrome • Urine ... #algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
• Hypovolemia: Diuretics ... Liver Cirrhosis, Nephrotic ... Syndrome, Chronic ... Renal Failure, ... #sodium #low
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
• Metabolic alkalosis ... kidney disease, and nephrotic ... syndromeHyponatremia ... #Diuresis #Nephrology ... #Medications #Table