Disturbances in salt and water balance – AMBOSS podcast 95
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Salt is essential for humans - and so is knowing about it. Around 15% of all patients in the emergency room show hyponatremia. But although we encounter disturbances in sodium and water balance almost every day, we often find it difficult to diagnose and treat them. To eliminate this Achilles heel, nephrologist Dr. Matthias Janneck takes us through three clinical cases on this relevant topic in the AMBOSS podcast. When should you increase the dose of the diuretic despite high retention parameters? Why can it make sense to limit the amount you drink and at the same time administer a full electrolyte solution? And how do you treat acute hyponatremia after ecstasy consumption? In this episode, the head of the Nephrology Section at Hamburg's Albertinen Hospital explains in a practical and application-oriented way what is important in diagnostics and how successful therapy can be achieved. Table of contents: 00:00 Intro 01:32 Clinical relevance 03:27 Aldosterone and volume regulation 06:25 ADH and osmoregulation 08:02 The role of blood pressure 09:36 Lots of flow charts – no overview? 12:39 1st case: hyponatremia in heart failure 18:05 Diuretics and fluid restriction despite poor kidney values 20:44 “Salt tablets”: A medical malpractice 22:37 2nd case: hyponatremia in SIADH 25:56 Serum and urine diagnostics in SIADH 30:08 Treatment of SIADH 36:20 Central pontine myelinolysis 38:39 3rd case: hyponatremia in diarrhea 42:55 No contradiction: fluid restriction and full electrolyte solution 46:52 Tips for medication history 49:41 Acute hyponatremia: An absolute emergency 56:14 Hypernatremia 01:00:57 Conclusion and outro **More information on SIADH in AMBOSS:* https://go.amboss.com/43fa2d **For the AMBOSS Sono course:* https://go.amboss.com/sonokurs **You can find the podcast summary at:* go.amboss.com/podcastimblog **For the AMBOSS chapter “Electrolyte imbalances sodium”:* https://go.amboss.com/natrium **More about the AMBOSS podcast:* https://go.amboss.com/podcast
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