低血鈉的鑑別診斷

TinyNotes

Answer

先按照osmolality分成三個大類

Hypertonic：
有另一個溶質(ex. 葡萄糖)，將水分拉入血管內
每增加100mg/dL的血糖，血中的鈉就會降低2.4mmol/L
Isotonic：
和高血脂相關的lab error (和儀器測定的方式有關
Hypotonic：
臨床上最為常見的低血鈉成因，可以再往下分類

Hypotonic hyponatremia，可以依照再體液狀態分成

Type	Cause
Hypervolemic	體內fluid overload	心臟衰竭、肝衰竭、腎臟衰竭導致體液過多，稀釋血鈉
Euvolemic	SIADH、甲狀腺機能低下、腎上腺機能低下、懷孕、 Primary polydipsia
Hypovolemic	分為腎臟流失及腎外流失	腎因性: Salt wasting nephropathy、利尿劑的使用；腎外性：腹瀉、嘔吐

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