The presentation of SIADH is similar to all forms of hyponatremia. Diagnosis is based on finding elevated urine osmolality and urine sodium. This is inappropriate to find in a patient with hyponatremia.
Hypervolemic hyponatremia is not a diagnosis. It is hyponatremia with a description of the volume status for people who follow the dx algorithm. The right diagnosis would be something like hyponatremia due to high ADH from low effective arterial blood volume from cirrhosis or CHF
Well I dont agree with assuming volemia means intravascular circulating blood volume. The basis of diferential diagnosis of hyponatremia based on hypovolemic, euvolemic and hypervolemic relies completely on the concept volemia=total body sodium and is physiologically clear!!
FINAL DIAGNOSIS: Hypo-osmolar hyponatremia caused by cerebral salt wasting syndrome in the course of non-Hodgkin lymphoma with brain lesions. In CSW, volume expansion should target correction of hyponatremia by not more than 8 to 10 mmol/L per day http://bit.ly/28QUutY (FREE)pic.twitter.com/rxYnLs086J
I think for non-renal/nephro ppl, the diagnosis you mentioned would be outrageous or unreal to write in notes. I think writing hypervolumic Hyponatremia is okay as diagnosis but just be elobrated on more with whether it’s related to heart failure nephrotic syndrome liver etc.
Almost all HRS r hypoNatremic. In fact, could b argued that when hypoNatremia is absent, u should question the HRS diagnosis. As @NephRodby points out, AVP-led water retention should not drive the FENa down. Maybe it’s all coz magnitude of SNS/RAS activation (HRS vs hypovolemia