العلاج الأول لمتلازمة إفراز الهرمون المضاد لإدرار البول بشكل غير ملائم

DOI: 10.1016/j.amjmed.2013.07.006

• For most other cases of mild-to-moderate SIADH, fluid restriction represents the cheapest and least toxic therapy and has generally been the treatment of choice despite the almost complete lack of a supportive evidence base.
• Generally, discretionary (ie, nonfood) fluids should be limited to 500 mL/d below the average daily urine volume.
• Only fluid, not sodium or protein intake, should be restricted.
• At the time that fluid restriction is first initiated, any drugs known to be associated with SIADH should be discontinued or changed.
• Several days of restriction are usually necessary before a significant increase in plasma osmolality occurs.
• Once the serum [Na+] has reached 125 mmol/L, the risk of CNS complications of hyponatremia is low.