Syndrome of inappropriate antidiuretic hormone secretion
ICD-10 E22.2 · ICD-11 5A60.2

Treatment of SIADH in Chronic Hyponatraemia Without Severe Symptoms and Normal Volume Status

Clinical Scenario

This protocol applies to patients with chronic hyponatraemia due to syndrome of inappropriate antidiuresis (SIAD) who present without severe or moderately severe symptoms and with normal volume status — a clinically distinct presentation that calls for a specific, structured management approach.

Management Approach

In moderate or profound hyponatraemia in this setting, certain solute-based interventions may be considered — the full protocol details the specific options, how they compare, and how they are applied. The complete regimen is available below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1530/EJE-13-1020

For demeclocycline and lithium, there is some evidence of possible harm, so we advise against their use for management of any degree of chronic hyponatraemia in patients with SIAD.

In moderate or profound hyponatraemia, we suggest the following can be considered equal second-line treatments: increasing solute intake with 0.25–0.50 g/kg per day of urea or a combination of low-dose loop diuretics and oral sodium chloride (2D).

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