Differentiating etiologies of Hypernatremia: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 30: | Line 30: | ||
!Other | !Other | ||
|- | |- | ||
!'''[[Central diabetes insipidus]]''' | !'''[[Central diabetes insipidus]]<ref name="pmid27213601">{{cite journal |vauthors=Arndt C, Wulf H |title=[Hypernatremia - Diagnostics and therapy] |language=German |journal=Anasthesiol Intensivmed Notfallmed Schmerzther |volume=51 |issue=5 |pages=308–15 |date=May 2016 |pmid=27213601 |doi=10.1055/s-0041-107265 |url=}}</ref>''' | ||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
|<nowiki>Polyuria</nowiki> | |<nowiki>Polyuria</nowiki> | ||
| Line 69: | Line 69: | ||
|<nowiki>Desmopressin stimulation test: Not significant change in urine osmolality</nowiki> | |<nowiki>Desmopressin stimulation test: Not significant change in urine osmolality</nowiki> | ||
|- | |- | ||
!'''[[GI loss]]''' | !'''[[GI loss]]<ref name="pmid26810623">{{cite journal |vauthors=Chisti MJ, Ahmed T, Ahmed AM, Sarker SA, Faruque AS, Islam MM, Huq S, Shahrin L, Bardhan PK, Salam MA |title=Hypernatremia in Children With Diarrhea: Presenting Features, Management, Outcome, and Risk Factors for Death |journal=Clin Pediatr (Phila) |volume=55 |issue=7 |pages=654–63 |date=June 2016 |pmid=26810623 |doi=10.1177/0009922815627346 |url=}}</ref>''' | ||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
|<nowiki>Oligouria</nowiki> | |<nowiki>Oligouria</nowiki> | ||
Revision as of 23:35, 8 July 2018
|
Hypernatremia Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Differentiating etiologies of Hypernatremia On the Web |
|
American Roentgen Ray Society Images of Differentiating etiologies of Hypernatremia |
|
Risk calculators and risk factors for Differentiating etiologies of Hypernatremia |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aida Javanbakht, M.D.
Overview
Hypernatremia must be differentiated from other diseases that cause
Differentiating Hypernatremia from other Diseases
| Disease | Clinical manifestations | Paraclinical Findings | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms and Signs | Lab Findings | ||||||||||
| Confusion/ Irritable | Urine output | Vomiting/ Diarrhea | Volume status | Seizure | Blood pressure | Dry mucous membranes | Other | ||||
| Urine Osm | Serum Na | Other | |||||||||
| Central diabetes insipidus[1] | + | Polyuria | - | Hypovolemic | + | Could be high | + | - | <250 mOsm/kg | May be >170 mEq/L | Low arginin vasopressin level |
| Hyperosmolar hyperglycemic | + | Polyuria | - | Hypovolemic | + | Could be low | + | Abdominal pain | Could be normal | May be >145 mEq/L | Elevated serum glucose level and creatinine |
| Nephrogenic diabetes insipidus | + | Polyuria | - | Hypovolemic | + | Could be low | + | History of taking Gentamicin, Lithium, Rifampin | <250 mOsm/kg | May be >170 mEq/L | Desmopressin stimulation test: Not significant change in urine osmolality |
| GI loss[2] | + | Oligouria | + | Hypovolemic | + | Could be low | + | History of contact with infected food or peaople | <250 mOsm/kg | May be >145 mEq/L | Desmopressin stimulation test: Not significant change in urine osmolality |
| Crohn (intestinal fistula) | - | Normal | Could be + | Normal | - | Normal | + | - | <250 mOsm/kg | May be >145 mEq/L | Cobblestone mucosa in colonoscopy |
| Heat strock[3] | + | oligouria | - | Hypovolemic | + | Could be low | + | Suken eye, Sweating | >250 mOsm/kg | May be >145 mEq/L | Hypokalemia |
| Essential hypernatremia( primary hypodipsia) | - | Oligouria | - | Hypovolemic | - | Could be low | + | - | >250 mOsm/kg | May be >145 mEq/L | Low arginin vasopressin level |
| Cushing syndrome | + | Polyuria | - | Hypervolemia | + | Could be high | + | Moon face, truncal obesity | Could be normal | May be >145 mEq/L | 24-hour urinary free cortisol test: >50 microgram |
| Loop and Osmotic Diuretic | + | Polyuria | - | Hypovolemic | + | Could be low | + | Sunken eye | Could be normal | May be >145 mEq/L | Hypokalemia might be seen |
References
- ↑ Arndt C, Wulf H (May 2016). "[Hypernatremia - Diagnostics and therapy]". Anasthesiol Intensivmed Notfallmed Schmerzther (in German). 51 (5): 308–15. doi:10.1055/s-0041-107265. PMID 27213601.
- ↑ Chisti MJ, Ahmed T, Ahmed AM, Sarker SA, Faruque AS, Islam MM, Huq S, Shahrin L, Bardhan PK, Salam MA (June 2016). "Hypernatremia in Children With Diarrhea: Presenting Features, Management, Outcome, and Risk Factors for Death". Clin Pediatr (Phila). 55 (7): 654–63. doi:10.1177/0009922815627346. PMID 26810623.
- ↑ Morley JE (August 2015). "Dehydration, Hypernatremia, and Hyponatremia". Clin. Geriatr. Med. 31 (3): 389–99. doi:10.1016/j.cger.2015.04.007. PMID 26195098.