Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome ...
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Causes of Hyponatremia - Differential Diagnosis Algorithm

Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to ADH

 • Pain/Post-op

 • Neurologic trauma

 • Drugs

 • Pulmonary pathology

 • Malignancy

True hypovolemia

 • Bleeding

 • GI losses

 • Renal losses (especially thiazide diuretics)

With edema

 • Congestive heart failure

 • Cirrhosis

 • Nephrotic syndrome

 • Reduced GFR, AKI/CRF

Hormonal changes

 • Hypothyroidism

 • Adrenal insufficiency

 • Pregnancy

Hypo-osmolar urine - Uosm < 100 mmol/kg - ADH suppression

 • Primary polydipsia

 • Insufficient osmole intake



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