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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Hyponatremia - Differential Diagnosis and Evaluation Algorithm
In addition to edema and urine concentration, always consider urine
Hyponatremia - Differential ... Diagnosis and Evaluation ... Algorithm In addition ... Diagnosis #Evaluation ... #Algorithm #nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... #Differential # ... Diagnosis #Algorithm ... #causes #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... mmol/L - true hyponatremia ... hypothyroidism • adrenal ... #Diagnosis #Workup ... #Algorithm #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
- Differential ... Diagnosis Algorithm ... Hypothyroidism • Adrenal ... #Nephrology #Differential ... #Diagnosis #Algorithm
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... High Uric Acid → renal ... Diagnosis #Algorithm ... #nephrology #sodium
Acute Kidney Injury (AKI) - Differential Diagnosis Framework
Pre-Renal:
 • Hypovolemia, Cardiorenal, Distributive Shock, HRS, Hypercalcemia, Renal
Injury (AKI) - Differential ... Diagnosis Framework ... Kidney #Injury #Differential ... #Diagnosis #nephrology ... #causes #algorithm
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
True Hyponatremia ... Differential Algorithm ... #Differential # ... Algorithm #Diagnosis ... #Nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... solute intake, Renal ... #diagnosis #differential ... #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... Hypothyroidism, Adrenal ... #differential # ... diagnosis #table ... #sodium #nephrology
Hyponatremia - Differential Diagnosis by Mechanism
Decr Blood Pressure (“Decr Effective Circulating Volume”) 
 - Volume depletion
Hyponatremia - Differential ... Diagnosis by Mechanism ... Hypothyroidism - Adrenal ... #Differential # ... Diagnosis #Table