26 results
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Osmolarity 2) Urine ... Osmolarity 3) Urine ... Uric Acid - Low ... Uric Acid → SIADH
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
uric acid >4 • Urine ... Extra-renal losses • Urine ... uric acid <4 • SIADH ... uric acid >4 • Urine ... Nephrotic syndrome • Urine
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
examination, check urine ... uric acid: - Urine ... sodium low, uric ... - Urine sodium ... and uric acid low
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Salt Wasting vs SIADH ... → Increased urine ... #SaltWasting #SIADH ... diagnosis #nephrology #hyponatremia
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
volume-based algorithm Urine ... restriction alone in SIADH ... Present (Uosm ≥100): SIADH ... can be high or low ... Primary polydipsia), Low
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... Diagnosis Algorithm Hypernatremia ... 145 mmol/L High Urine ... mannitol, glucosuria Low ... Urine Osmolality
Hyponatremia - Diagnostic Evaluation Algorithm

Step 1: Consider whether Posm may actually be normal or elevated
Step 2:
Hyponatremia - Diagnostic ... Check Uosm and/or Urine ... tests Step 5: If SIADH ... DrEricStrong #Hyponatremia
A lazy man's classification of hyponatremia
There are two possible approaches to the diagnosis of hyponatremia: .
classification of hyponatremia ... the diagnosis of hyponatremia ... serum osmolality, urine ... the patient has SIADH ... #Diagnosis #Hyponatremia
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... colon 0.9% Normal Saline ... : • If Urine osmolality ... SatyaPatelMD #SIADH ... #Management #hyponatremia
Management of Hyponatremia
Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125
Give
Management of Hyponatremia ... • Discuss with endocrinology ... — discuss with endocrinology ... Normalizes in SIADH ... • IF SIADH