Hyponatremia in Syndrome of inappropriate antidiuresis Hyponatremia Treatment Furosemide Fluid restriction Salt tablet
Conditions
Interventions
Restrict oral fluid intake per day depending on ratios of urine sodium plus urine potassium divided by serum sodium,Fluid restriction as arm 1 plus furosemide 20-
40 mg/day,Fluid restriction as arm 1 plus furosemide 20-
40 mg/day plus salt tablet 3 grams/day
Placebo Comparator Behavioral,Active Comparator Drug,Active Comparator Drug
Fluid restriction alone ,fluid restriction plus furosemide,fluid restriction plus furosemide plus salt tablet
Sponsors
Renal Division, Department of Internal Medicine, Chiang Mai University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: - Age of more than 18 years old - Serum sodium ≤130 mmol/L - Chronic hyponatremia (>48 hour after onset or unknown onset) - Diagnosis of SIAD, all following criterion must be met: - Effective serum osmolality100 mOsm/kg H2O - Clinical euvolemia - Urine sodium concentration >30 mmol/L with normal dietary salt and water intake - Absence of hypothyroidism (thyroid-stimulating hormone 1.2 or diagnosed as acute kidney injury)
Exclusion criteria
Exclusion criteria: - Clinical overt hypovolemia or hypervolemia - Decompensated liver cirrhosis, symptomatic heart failure, and nephrotic syndrome - Hemodynamic unstable - Current using investigational agents (salt tablet or furosemide), other diuretics and steroids - Severe symptomatic hyponatremia at diagnosis (defined as vomiting, cardiorespiratory distress, abnormal and deep somnolence, seizures, and coma (which define as Glasgow Coma Scale 8) - Hyperglycemia enough to interfere with assessment of serum sodium, defined as random plasma glucose >300 mg/dL at the time of diagnosis - Receiving renal replacement therapy - Post kidney transplant status - Furosemide allergy - Contraindicated for eating or feeding via enteral route
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Serum sodium concentration Day 4 and day 28 after randomization Ion selective electrode system (Cobas 6000 & Cobas 8000, Roche, USA) | — |
Secondary
| Measure | Time frame |
|---|---|
| Percentage of patients with normal serum sodium concentration Day 4 and day 28 after randomization Number of patients with normal serum sodium concentration divided by total number of patients in th ,Adverse effects of furosemide, salt tablet and fluid restriction Day 0-28 after randomization Observations of adverse effects | — |
Countries
Thailand
Contacts
Public ContactKajohnsak Noppakun
Chiang Mai University
Outcome results
None listed