NEPHROLOGY
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NEPHROLOGY
“The cause of hyponatremia can be determined in part by how the patient’s kidneys are responding to the condition. If the urine is appropriately dilute, then the most likely cause of hyponatremia is excessive water intake or inadequate solute intake. Conversely,...
NEPHROLOGY
Info in the following table is from AAFP 2015 (algorithm) and Pocket Medicine TBW TBS Causes & Treatment Hypovolemic hypotonic hyponatremia ↓TBW ↓↓ TBS Renal losses ( UNa >20 mEq/L, FENa > 1%) – Diuretics, salt-wasting nephropathy, cerebral salt...
NEPHROLOGY
Step 1: Determine the duration of hyponatremia Is this acute (<48 h) or chronic (>48 h)? The duration determines how fast you should correct the sodium. You rapidly correct acute and slowly correct chronic hyponatremia. Step 2: Determine the severity (degree) of...
NEPHROLOGY
Principles Principle #1: Disorders of serum sodium are generally caused by changes in total body water, not total body sodium. The serum/plasma sodium concentration is regulated by changes in water intake and water excretion, not by changes in total body sodium. That...
NEPHROLOGY
What’s urine osmolality useful for? Urine osmolality is useful for assessing the concentrating and diluting ability of the kidney. “Urine Osmolality is an indirect functional assay of the ADH-renal axis. Urine Osmolality range: 50 mOsm/L (no ADH) to 1200 mOsm/L...
