{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:56:41Z","timestamp":1792515401180,"version":"4.5.0"},"reference-count":344,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T00:00:00Z","timestamp":1679961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National Health and Medical Research Council of Australia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Hyponatremia is the most common electrolyte disorder, affecting more than 15% of patients in the hospital. Syndrome of inappropriate antidiuresis (SIAD) is the most frequent cause of hypotonic hyponatremia, mediated by nonosmotic release of arginine vasopressin (AVP, previously known as antidiuretic hormone), which acts on the renal V2 receptors to promote water retention. There are a variety of underlying causes of SIAD, including malignancy, pulmonary pathology, and central nervous system pathology. In clinical practice, the etiology of hyponatremia is frequently multifactorial and the management approach may need to evolve during treatment of a single episode. It is therefore important to regularly reassess clinical status and biochemistry, while remaining alert to potential underlying etiological factors that may become more apparent during the course of treatment. In the absence of severe symptoms requiring urgent intervention, fluid restriction (FR) is widely endorsed as the first-line treatment for SIAD in current guidelines, but there is considerable controversy regarding second-line therapy in instances where FR is unsuccessful, which occurs in around half of cases. We review the epidemiology, pathophysiology, and differential diagnosis of SIAD, and summarize recent evidence for therapeutic options beyond FR, with a focus on tolvaptan, urea, and sodium-glucose cotransporter 2 inhibitors.<\/jats:p>","DOI":"10.1210\/endrev\/bnad010","type":"journal-article","created":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T16:11:44Z","timestamp":1680019904000},"page":"819-861","source":"Crossref","is-referenced-by-count":144,"title":["Syndrome of Inappropriate Antidiuresis: From Pathophysiology to Management"],"prefix":"10.1210","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7287-6162","authenticated-orcid":false,"given":"Annabelle M","family":"Warren","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Melbourne , Victoria 3010 , Australia"},{"name":"Department of Endocrinology, The Austin Hospital , Victoria 3084 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathis","family":"Grossmann","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Melbourne , Victoria 3010 , Australia"},{"name":"Department of Endocrinology, The Austin Hospital , Victoria 3084 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Christ-Crain","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel , Basel 4031 , Switzerland"},{"name":"Department of Clinical Research, University of Basel and University Hospital Basel , Basel 4031 , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Russell","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Melbourne , Victoria 3010 , Australia"},{"name":"Department of Endocrinology, The Austin Hospital , Victoria 3084 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2023,3,28]]},"reference":[{"issue":"4","key":"2023091509053963000_bnad010-B1","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/0002-9343(57)90224-3","article-title":"A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone","volume":"23","author":"Schwartz","year":"1957","journal-title":"Am J Med"},{"issue":"7 Suppl 1","key":"2023091509053963000_bnad010-B2","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1016\/j.amjmed.2006.05.004","article-title":"Whole-body volume regulation and escape from antidiuresis","volume":"119","author":"Verbalis","year":"2006","journal-title":"Am J Med"},{"issue":"10 Suppl 1","key":"2023091509053963000_bnad010-B3","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.amjmed.2013.07.006","article-title":"Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations","volume":"126","author":"Verbalis","year":"2013","journal-title":"Am J Med"},{"issue":"5","key":"2023091509053963000_bnad010-B4","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/0002-9343(67)90096-4","article-title":"The syndrome of inappropriate secretion of antidiuretic hormone","volume":"42","author":"Bartter","year":"1967","journal-title":"Am J Med"},{"issue":"2","key":"2023091509053963000_bnad010-B5","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/00007611-199302000-00027","article-title":"Pseudohyponatremia in multiple myeloma","volume":"86","author":"Vaswani","year":"1993","journal-title":"South Med J"},{"issue":"9","key":"2023091509053963000_bnad010-B6","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1056\/NEJM199808273390914","article-title":"Intravenous immune globulin and pseudohyponatremia","volume":"339","author":"Lawn","year":"1998","journal-title":"N Engl J Med"},{"issue":"15","key":"2023091509053963000_bnad010-B7","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1056\/NEJMcps031078","article-title":"Clinical problem-solving. 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