Hypernatremia differential diagnosis
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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 | + | 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/nowiki> |- !'''[[Nephrogenic diabetes insipidus]]''' |<nowiki>+ | Polyuria | - | Hypovolemic | + | Could be low | + | History of taking Gentamicin, Lithium, Rifampin | <250 mOsm/kg | May be >170 mEq/L | <nowiki>Desmopressin stimulation test: Not significant change in urine osmolality}
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