Nephrology Book

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Hypervolemic Hypoosmolar Hyponatremia

Aka: Hypervolemic Hypoosmolar Hyponatremia
  1. See Also
    1. Hyponatremia
    2. Hyperosmolar Hyponatremia
    3. Normoosmolar Hyponatremia
    4. Hypoosmolar Hyponatremia
    5. Hypovolemic Hypoosmolar Hyponatremia
    6. Isovolemic Hypoosmolar Hyponatremia
    7. Hyponatremia Management
    8. Sodium and Water Homeostasis
  2. Pathophysiology
    1. Edematous state reduces effective circulating volume
    2. Decreased flow to nephron diluting segment
    3. Stimulates ADH release
  3. Causes
    1. Edematous States
      1. Urine Sodium < 10-15 meq/L (if no Diuretic use)
      2. Urine Osmolality >350 mOsm/kg water
      3. Conditions
        1. Cirrhosis
        2. Congestive Heart Failure
        3. Nephrotic Syndrome
    2. Advanced Renal Insufficiency
      1. Urine Sodium > 20 meq/L
  4. Diagnostics (consider)
    1. Chest XRay
    2. Electrocardiogram
    3. Echocardiogram
    4. IVC Ultrasound for Volume Status
      1. Ultrasound may also demonstrate Ascites in Cirrhosis
  5. Labs
    1. Urinalysis
    2. Urine Protein to Creatinine Ratio
    3. Comprehensive metabolic panel (Renal Function tests, Liver Function Tests)
    4. Brain Natriuretic Peptide
  6. Management
    1. See Hyponatremia Management
    2. Salt and water restriction
    3. Optimize Cardiac Output
    4. Consider Dialysis for Renal Insufficiency
    5. Consider Diuretics
  7. References
    1. Kone in Tisher (1993) Nephrology, p. 87-100
    2. Levinsky in Wilson (1991) Harrison's IM, p. 281-84
    3. Rose (1989) Acid-Base and Electrolytes, p. 601-38
    4. Braun (2015) Am Fam Physician 91(5): 299-307 [PubMed]

Hyponatremia with excess extracellular fluid volume (C0268816)

Concepts Disease or Syndrome (T047)
SnomedCT 42669007
English Hyponatremia with excess extracellular fluid volume, Hyponatraemia with excess extracellular fluid volume, Hyponatremia with excess extracellular fluid volume (disorder)
Spanish hiponatremia con aumento de volumen del líquido extracelular (trastorno), hiponatremia con aumento de volumen del líquido extracelular
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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