AM Report 11/7/16: Primary Polydipsia

Remember to check plasma osmolality first!

1

Next evaluate volume status!

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If a patient is Euvolemic – evaluate urine osmolality and sodium

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Practical approach to hyponatremia:

1.What is the normal/abnormal physiology?

2.Is it “true” hypo-osmolar hyponatremia?

  • Measure plasma osmolality

3.What is the volume and ADH status?

  • Urine Na and Urine Osmolality

4.Is it symptomatic?

5.What is my treatment?

  • Depends on volume status, ADH status, and +/- symptoms
  • Determine goal of correction
  • Avoid overcorrection

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