Efficacy of Low-Dose Tolvaptan for Treatment of Profound Hyponatremia in Syndrome of Inappropriate Antidiuresis (SIAD): The EFFLUX-FLUID TRIAL

Kidney Medicine 2026 Open access

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Authors: Narongchai Jaiyen, Sutatip Chinpraditsuk, Pattharawin Pattharanitima, Pichaya Tantiyavarong, Pajaree Krisanapan
DOI: 10.1016/j.xkme.2025.101239
Cited by: 1
References: 22

Abstract

Rationale & Objective Although tolvaptan is effective for treating hyponatremia in the syndrome of inappropriate antidiuresis (SIAD), fluid restriction remains the first-line therapy because of safety concerns. This study evaluated whether low-dose tolvaptan is more effective than a combination of fluid restriction, furosemide, and sodium chloride tablets in patients with profound hyponatremia and clinical predictors of fluid restriction failure. Study Design Single-center, open-label, randomized controlled trial. Setting & Participants Hospitalized adults with chronic SIAD and serum sodium concentration [Na + ] ≤125 mmol/L, meeting ≥ 1 predictor of fluid restriction failure (urine osmolality >500 mOsm/kg H 2 O, sum of urine sodium and potassium > [Na + ], or urine volume

Fields of Study & Subjects

Electrolyte and hormonal disorders Heart Failure Treatment and Management Ion Transport and Channel Regulation

Publication details

Journal / source
Kidney Medicine
Publisher
Elsevier BV
Volume
8
Issue
3
Pages
101239–101239
Publication date
5 January 2026
Language
EN