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Сообщение от katerpiller74
... на 11-12 день снижается уровень натрия до критических цифр...
Прошу помочь в разъяснении ситуации, отправить к первоисточникам.
С уважением Кудрявцев Антон.
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D/Diagnosis of Hypotonic Hyponatremia
•
Hypovolemic
TBW-
TBNa--
» Urine Sodium: >20 mmol/L
» Diagnosis: Renal Losses:
Diuretic Therapy
Osmotic Diuresis
Salt-Wasting Nephropathy
Adrenal Insufficiency (Mineralocorticoid def)
Proximal Renal Tubular Acidosis
Metabolic Alkalosis
Pseudohypoaldosteronism
Cerebral Salt-Wasting
• Hypovolemic
TBW-
TBNa--
» Urine Sodium: <20 mmol/L
» Diagnosis: Extrarenal Losses:
Gastrointestinal
Sweat
Third Space (Burns, Ascites, Effusions)
• Euvolemic
TBW+
TBNa+-
» Urine Sodium: >20 mmol/L
» Diagnosis: Excess ADH (SIADH*, Drugs, Pain)
Water Intoxication (IV Therapy, Psychogenic Water Drinking, Tap Water Enema)
Reset Osmostat
Glucocorticoid Deficiency
Hypothyroidism
• Hypervolemic
TBW++
TBNa+
» Urine Sodium: <20 mmol/L
» Diagnosis: Edematous Congestive Heart Failure
Cirrhosis
Nephrotic Syndrome
• Hypervolemic
TBW++
TBNa+
» Urine Sodium: >20 mmol/L
» Diagnosis: Renal Failure (Acute or Chronic)
TBW= Total body water; TBNa= Total body sodium