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nephrology diagnosis differential algorithm management causes table hypernatremia hypokalemia workup cardiology clinical criticalcare excretion foamed gitelman goal heartfailure hyperkalemia hypomagnesemia
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
• Euvolemic (Low ... • Hypovolemic: Diuretics ... osmotic (solute) diuresis ... , Cushing syndrome ... #sodium
Hyponatremia Correction 1. Indications for Hypertonic Saline: seizure, coma, focal findings - typically occurs with
Hyponatremia Correction ... 100-110 - Symptoms ... Demyelination Syndrome ... 3cc/kg/h, loop diuretics ... desmopressin MH/CCF
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
Sodium loss (diuretics ... deficiency, Post-AKI diuresis ... (AKI, Post-AKI diuresis ... Cirrhosis, Nephrotic syndrome ... #nephrology
Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Repeat the sodium ... volume loss - diuretics ... HYPERVOLEMIC • CHF ... • nephrotic syndrome ... Workup #Algorithm #Nephrology
Diuretics and Agents Regulating Renal Excretion Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide) • Glaucoma • Epilepsy • Altitude
Diuretics and Agents ... Tolvaptan) • Treatment ... #Diuretics # ... #Diuresis #Nephrology ... #Pharmacology #
Hypokalemia - Differential Diagnosis Algorithm Transcellular Shift: • Alkalosis • ↑ beta-2 adrenergic simulation • Erythropoiesis
anemia) • G-CSF ... • Refeeding syndrome ... vomiting) • Low ... • Discontinued diuretic ... #low #potassium
Causes of Hypomagnesemia • Redistribution: IV glucose, Correction of diabetic ketoacidosis, IV hyperalimentation, Refeeding after starvation,
Redistribution: IV glucose, Correction ... Saline or osmotic diuresis ... , Potassium depletion ... • Drugs: Loop diuretics ... #magnesium #low
Management of Hyponatremia Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125 Give
Management of Hyponatremia ... patient has severe symptoms ... Failure - Add Diuretics ... Add Diuretics, Consider ... #sodium
Hyponatremia - Differential Algorithm Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP Hypotonic Hyponatremia: • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
• Hypovolemia: Diuretics ... Cirrhosis, Nephrotic Syndrome ... , Chronic Renal ... Alcohol MH/CCF ... #sodium #low
Hyperkalemia - Diagnosis and Management - GrepMed Handbook S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
G-K), K-sparing diuretics ... improve GFR - Diuresis ... (IV loop diuretic ... - IV loop diuretic ... #potassium #nephrology
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