Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Pain/Post-op • Neurologic ... GI losses • Renal ... • Reduced GFR, AKI ... #Nephrology #Differential
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Tea and Toast Syndrome ... Beer Potomania - Low ... #causes #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... normal volume-based algorithm ... can be high or low ... Cirrhosis, Nephrotic syndrome ... table #sodium #nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... Primary polydipsia, Low ... solute intake, Renal ... #causes #nephrology
Hypokalemia - Differential Diagnosis Algorithm
Extra-renal Losses:
 • Normal Acid-Base: Low intake
 • Metabolic acidosis: Gl tract
Differential Diagnosis Algorithm ... Extra-renal Losses ... loss (Diarrhea) Renal ... #causes #potassium ... #low #nephrology
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
Workup Algorithm ... osmolarity If cause ... syndrome: troponin ... Differential #Diagnosis #nephrology ... #causes
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... High Uric Acid → renal ... #nephrology #sodium ... #low #uricacid
Acute Kidney Injury (AKI) - Differential Diagnosis Framework
Pre-Renal:
 • Hypovolemia, Cardiorenal, Distributive Shock, HRS, Hypercalcemia, Renal
Kidney Injury (AKI ... Abdominal Compartment Syndrome ... Medicine @SCVMCMed #AKI ... Differential #Diagnosis #nephrology ... #causes #algorithm
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... • nephrotic syndrome ... • renal failure ... Diagnosis #Workup #Algorithm ... #Nephrology
Hypophosphatemia Diagnostic Algorithm
- GI Losses
- Redistribution
- 1° HPT
- 1° Renal PO4 wasting: Hereditary, TIO, Fanconi Syndrome,
- 1° HPT - 1° Renal ... , TIO, Fanconi Syndrome ... Hypophosphatemia #phosphorus #low ... #diagnosis #Algorithm ... #differential #nephrology