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SIADH — Diagnose Safely, Correct Slowly

Hyponatremia with low serum osmolality. Exclude endocrine/diuretic causes, confirm SIADH with urine studies, and correct at safe rates.

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Urine osmolality/Na to support SIADH

Correct slowly; set targets and use hypertonic saline only for severe symptoms

Exclude hypothyroidism, adrenal insufficiency, and diuretics; assess volume

Treat cause; fluid restriction ± salt tabs/loop; consider vaptan selectively

Confirm hypotonic hyponatremia (serum osmolality)

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