2009 results
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia Algorithm ... Hyperglycemia, Mannitol ... , Medications (diuretics ... #Hyponatremia #Algorithm
Drug Induced Kidney Injury
 • Pre-Renal: NSAIDS, CNI, ACEI/ARB, IL-2 therapy, Diuretics CAR-T therapy
 • Osmotic
IL-2 therapy, Diuretics ... IVIG( sucrose), Mannitol ... differential #diagnosis #algorithm
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
hyperglycemia • mannitol ... volume loss - diuretics ... Diagnosis #Workup #Algorithm
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Differential Diagnosis Algorithm ... administration • Osmotic diuresis ... scheme) e.g., mannitol ... Differential #Diagnosis #Algorithm
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
- Differential Algorithm ... • Hypovolemia: Diuretics ... Hyperglycemia, Mannitol ... #Differential #Algorithm
Causes of Polyuria - Differential Diagnosis Algorithm
Polyuria - Urine Output > 3L/day, Increased Urine Volume (>2ml/min)
Osmotic
Differential Diagnosis Algorithm ... /min) Osmotic Diuresis ... Mellitus) • Mannitol ... Differential #Diagnosis #Algorithm
Diuretics sites of action on the nephron
1) Acetazolamide (carbonic anhydrase inhibitor)
2) Osmotic diuretics (e.g. mannitol)
3) Loop
Diuretics sites ... inhibitor) 2) Osmotic diuretics ... (e.g. mannitol) ... 3) Loop diuretic ... Thiazides-type diuretics
Nephron Pathophysiology - Diuretic Sites of Action
Diuretics
1) Acetazolamide/canagliflozin
2) Osmotic agents (mannitol, urearetics)
3) Loop agents (eg, furosemide)
4)
Pathophysiology - Diuretic ... Sites of Action Diuretics ... Osmotic agents (mannitol ... Pathophysiology #Diuretics
Treatment of hyperkalemia via kaliuresis 
step 1 = volume resuscitation if hypovolemic
step 2 = consider fludrocortisone
step
fludrocortisone step 3 = diuretic ... determine response to diuretic ... criticalcare #treatment #diuretics ... #diuresis #nephrology ... #algorithm
Summary of Diuretic Agents 
Subclass, Drug, Mechanism of Action, Effects, Clinical Applications, Pharmacokinetics, Toxicities, Interaction
CARBONIC ANHYDRASE
Summary of Diuretic ... empagliflozin LOOP DIURETICS ... POTASSIUM-SPARING DIURETICS ... • Mannitol VASOPRESSIN ... Tolvaptan #Diuretics