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When do you consider pharmacologic therapies such as sodium tablets, urea, vaptans, etc., vs conservative management for persistent asymptomatic hyponatremia in hospitalized patients?

When considered, how do you decide which agent(s) to initiate/titrate?
1 Answer
Mednet Member
Mednet MemberInvited Expert
Hospital Medicine · Emory University Hospital
Answered on

For patients with SIADH, I consider active therapy in one of the following scenarios:

  1. Na remains <130, especially <125–128, despite 24–48 h of appropriate conservative management.
  2. Fluid restriction is not feasible (thirst, tube feeds, need for hydration, patient cannot adhere).
  3. The patient has recu...

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