11 results
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
to Hypotonic Hyponatremia ... Sodium loss (diuretics ... diuresis can be ... diuresis) RAAS ... #sodium #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Hypernatremia: ... • Hypovolemic: Diuretics ... osmotic (solute) diuresis ... #nephrology #sodium
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... losses, Diuretic ... and metabolic alkalosis ... Ketonuria, Osmotic diuresis ... Cardiac failure #Hyponatremia
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... mmol/L - true hyponatremia ... volume loss - diuretics ... syndromerenal ... failure #Hypernatremia
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Euvolemic; no physiologic ... GI losses • Renal ... especially thiazide diuretics ... osmole intake #Hyponatremia
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Euvolemic; no physiologic ... GI losses • Renal ... especially thiazide diuretics ... osmole intake #Hyponatremia
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Hyponatremia: Hyperglycemia ... syndrome - ... , Medications (diuretics ... #sodium #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Hyponatremia - Differential ... • Hypovolemia: Diuretics ... Syndrome, Chronic ... Renal Failure, ... #sodium #low
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
• Metabolic alkalosis ... syndromeHyponatremia ... and euvolemic hyponatremia ... #Diuresis #Nephrology ... #Medications #Table
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... syndrome • Urine ... SatyaPatelMD #Volume #Hyponatremia ... #algorithm #diagnosis ... #sodium #low #nephrology