Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism ≤ 600 mOsm/kg - Implies renal mechanism 2) Volume Status Extrarenal Hypernatremia: • Hypovolemic (H2O loss): GI loss, Skin loss • Euvolemic (Low H2O intake): Impaired thirst, Lack of access to H2O • Hypervolemic (Excess salt intake): Iatrogenic, Ingestion Renal Hypernatremia: • Hypovolemic: Diuretics, osmotic (solute) diuresis • Euvolemic: Diabetes insipidus (central or nephrogenic) • Hypervolemic: Conn syndrome, Cushing syndrome Matthew Ho, MD PhD @MatthewHoMD #Hypernatremia #Differential #Diagnosis #Workup #Algorithm #nephrology #sodium
