Hyponatremia: Difference between revisions
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== Differential Diagnosis == |
== Differential Diagnosis == |
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* Pseudohyponatremia from lab error |
* [[Pseudohyponatremia]] from lab error |
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* Translational hyponatremia from mannitol or hyperglycemia |
* Translational [[hyponatremia]] from [[mannitol]] or [[hyperglycemia]] |
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* Hypovolemic |
* Hypovolemic |
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** U< |
** U<sub>Na</sub> >20: Renal losses, including [[mineralocorticoid deficiency]] |
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** U< |
** U<sub>Na</sub> <10: Non-renal losses |
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* Euvolemic |
* Euvolemic |
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** U< |
** U<sub>osm</sub> >100: [[SIADH]], [[hypothyroidism]], [[glucocorticoid deficiency]] |
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** U< |
** U<sub>osm</sub> <100: [[Primary polydipsia]], low solute intake |
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** U< |
** U<sub>osm</sub> variable: Reset osmostat |
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* Hypervolemic |
* Hypervolemic |
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** U< |
** U<sub>Na</sub> <10: CHD, [[cirrhosis]], [[nephrosis]] |
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** U< |
** U<sub>Na</sub> >20: [[Renal failure]] |
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== Investigations == |
== Investigations == |
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Revision as of 17:26, 30 July 2020
Differential Diagnosis
- Pseudohyponatremia from lab error
- Translational hyponatremia from mannitol or hyperglycemia
- Hypovolemic
- UNa >20: Renal losses, including mineralocorticoid deficiency
- UNa <10: Non-renal losses
- Euvolemic
- Uosm >100: SIADH, hypothyroidism, glucocorticoid deficiency
- Uosm <100: Primary polydipsia, low solute intake
- Uosm variable: Reset osmostat
- Hypervolemic
- UNa <10: CHD, cirrhosis, nephrosis
- UNa >20: Renal failure
Investigations
- Serum and urine osmolality and electrolytes (prior to treatment)
- TSH and AM cortisol
Further Reading
- Milionis HJ, Liamis GL, and Elisaf MS. The hyponatremic patient: a systematic approach to laboratory diagnosis. CMAJ. 2002;166(8):1056-1062.
