Management of SIADH
Treat underlying cause:
 • Causes ...

Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications, etc.
Free water restriction:
 • Restrict 1 to 1.5L per day
 • Can be difficult for patients to maintain long-term
Salt tablets:
 • Start with 1g NaCl PO TID
 • With lower Na, increase the number and frequency of salt tablets administered
 • Can cause volume overload
Urea powder:
 • 15-30g PO daily
 • Induces osmotic water elimination by promoting passive sodium reabsorption in the ascending limb of the loop of Henle
 • Contraindicated in cirrhosis given the potential for it to be metabolized into ammonium by urease-producing bacteria in the colon
0.9% Normal Saline:
 • If Urine osmolality < 538 AND UNa + UK < 154, can try giving a 250cc bolus of 0.9% NS
Vasopressor receptor antagonists:
 • Blocks ADH receptor
 • Has many side effects

Satya Patel, MD @SatyaPatelMD

#SIADH #Management #hyponatremia #nephrology #treatment
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Dr. Satya Patel
@SatyaPatelMD | Hospitalist  @LosAngelesVA | Anesthesiology Intern APD @UCLAHealth | Interested in medical education, curriculum design, and QI |
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