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Diagnosis and Management of Hypernatremia

#Hypernatremia #Differential #Algorithm #Causes #Nephrology #Diagnosis

** GrepMed Recommended Text: Nephrology Secrets -
of Hypernatremia ... Differential #Algorithm #Causes ... #Nephrology #Diagnosis ... GrepMed Recommended Text ... : Nephrology Secrets
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Cirrhosis, Nephrotic syndrome ... Cerebral salt wasting ... #Algorithm #diagnosis ... #sodium #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Osmolarity 3) Urine Sodium ... Acid → renal salt wasting ... #Algorithm #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... treat underlying cause ... cirrhosis, nephrotic syndrome ... UnremarkableLab #Hyponatremia ... #nephrology #sodium
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... • nephrotic syndrome ... #Diagnosis #Workup ... #Algorithm #Nephrology
Hypernatremia Differential Diagnosis Algorithm - Diabetes Insipidus Workup

Step #1 - Consider the history
Step #2 - Assess
Hypernatremia Differential ... Diagnosis Algorithm ... & desmopressin test ... Management #Algorithm #Sodium ... #nephrology #insipidus
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... - Differential Diagnosis ... #Differential #Diagnosis ... #Causes #nephrology ... #sodium #high
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Cerebral salt wasting ... Cirrhosis, Nephrotic syndrome ... #algorithm #diagnosis ... #sodium #low #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Algorithm Syndrome ... Pain/Post-op • Neurologic ... #Nephrology #Differential ... #Causes
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Algorithm Syndrome ... Pain/Post-op • Neurologic ... #Nephrology #Differential ... #Causes