Hypernatremia Diagnosis and Workup

Step 1 . Repeat ...
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Hypernatremia Diagnosis and Workup



Step 1 . Repeat the sodium concentration.

Step 2.  Check plasma osmolality.

NORMAL PLASMA OSMOLALITY 285-295 mmol/L - pseudohyponatremia

 • hyperlipidemia

 • hyperproteinemia

DECREASED PLASMA OSMOLALITY < 285 mmol/L - true hyponatremia

INCREASED PLASMA OSMOLALITY > 295 mmol/L - pseudohyponatremia

 • hyperglycemia

 • mannitol administration

Step 3. Assess volume status.

HYPOVOLEMIC

 • extra-renal volume loss

   - diarrhea

   - vomiting

   - burns

   - fevers

 • renal volume loss

   - diuretics

EUVOLEMIC

 • SIADH

 • hypothyroidism

 • adrenal insufficiency

 • psychogenic polydipsia

HYPERVOLEMIC

 • CHF

 • liver failure

 • nephrotic syndrome

 • renal failure



#Hypernatremia #Diagnosis #Workup #Algorithm #Nephrology
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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