Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause (CHF, cirrhosis, nephrotic syndrome)
Euvolemic
• UOsm < 200 - Inadequate Solute Intake
- Primary Polydipsia
- Beer Potomania
- Tea and Toast Diet
• UOsm > 300 - ADH Present and Active
- Appropriate ADH: Post Op. Pain. Stress, Nausea, Pulmonary Diseases, CNS Disease, Meds (Opiates, SSRIs)
- SIADH
- 4 to always exclude: CKD, Thiazides, Hypothyroidism, Glucocorticoid Deficiency
Unremarkable Labs @UnremarkableLab
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