Differentiating etiologies of Hypernatremia: Difference between revisions
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|<nowiki>Low arginin vasopressin level</nowiki> | |<nowiki>Low arginin vasopressin level</nowiki> | ||
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!'''[[Hyperosmolar hyperglycemic]]''' | !'''[[Hyperosmolar hyperglycemic]]<ref name="pmid25949947">{{cite journal |vauthors=Vigil D, Ganta K, Sun Y, Dorin RI, Tzamaloukas AH, Servilla KS |title=Prolonged hypernatremia triggered by hyperglycemic hyperosmolar state with coma: A case report |journal=World J Nephrol |volume=4 |issue=2 |pages=319–23 |date=May 2015 |pmid=25949947 |pmc=4419143 |doi=10.5527/wjn.v4.i2.319 |url=}}</ref>''' | ||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
|<nowiki>Polyuria</nowiki> | |<nowiki>Polyuria</nowiki> | ||
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|<nowiki>Desmopressin stimulation test: Not significant change in urine osmolality</nowiki> | |<nowiki>Desmopressin stimulation test: Not significant change in urine osmolality</nowiki> | ||
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!'''[[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> | ||
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|<nowiki>24-hour urinary free cortisol test: >50 microgram</nowiki> | |<nowiki>24-hour urinary free cortisol test: >50 microgram</nowiki> | ||
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!'''[[Loop and Osmotic Diuretic]]''' | !'''[[Loop and Osmotic Diuretic]]<ref name="pmid24410347">{{cite journal |vauthors=Khow KS, Lau SY, Li JY, Yong TY |title=Diuretic-associated electrolyte disorders in the elderly: risk factors, impact, management and prevention |journal=Curr Drug Saf |volume=9 |issue=1 |pages=2–15 |date=March 2014 |pmid=24410347 |doi= |url=}}</ref>''' | ||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
|<nowiki>Polyuria</nowiki> | |<nowiki>Polyuria</nowiki> | ||
Revision as of 23:40, 8 July 2018
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Hypernatremia Microchapters |
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Differentiating etiologies of Hypernatremia On the Web |
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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[2] | + | 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[3] | + | 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[4] | + | 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[5] | + | 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.
- ↑ Vigil D, Ganta K, Sun Y, Dorin RI, Tzamaloukas AH, Servilla KS (May 2015). "Prolonged hypernatremia triggered by hyperglycemic hyperosmolar state with coma: A case report". World J Nephrol. 4 (2): 319–23. doi:10.5527/wjn.v4.i2.319. PMC 4419143. PMID 25949947.
- ↑ 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.
- ↑ Khow KS, Lau SY, Li JY, Yong TY (March 2014). "Diuretic-associated electrolyte disorders in the elderly: risk factors, impact, management and prevention". Curr Drug Saf. 9 (1): 2–15. PMID 24410347.