Abstract: TH-PO0072
Comparative Efficacy of Protein Supplementation vs. Sodium Chloride Tablets in the Management of Syndrome of Inappropriate Antidiuresis: A Randomized Controlled Trial (PROSALT Trial)
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical Research
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolytes, and Acid-Base Disorders
- 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Naksawasdi, Thaya, Bhumibol Adulyadej Hospital, Bangkok, Thailand
- Pakchotanon, Kamolwan, Bhumibol Adulyadej Hospital, Bangkok, Thailand
Background
Syndrome of inappropriate antidiuresis (SIAD) is a common cause of chronic hyponatremia. Current therapies include fluid restriction, loop diuretics, vasopressin antagonists, and solute-based therapies such as sodium chloride tablets and urea. Sodium chloride tablets are commonly used in clinical practice, whereas evidence supporting protein supplementation remains limited. No randomized controlled trial has compared protein supplementation with sodium chloride tablets in chronic SIAD.
Methods
This open-label randomized controlled trial enrolled outpatients with chronic SIAD and serum sodium concentration <135 mEq/L. Participants were randomized to receive sodium chloride tablets 3.6 g/day or protein supplementation 60 g/day for 7 days. The primary outcome was change in serum sodium concentration at day 7. Secondary outcomes included achievement of serum sodium ≥135 mEq/L, adverse events, and patient satisfaction.
Results
A total of 25 participants were enrolled, including 13 in the sodium chloride group and 12 in the protein supplementation group. After 7 days of treatment, the median change in serum sodium concentration was 2 mEq/L (IQR, -3.0 to 3.0) in the protein group and 2 mEq/L (IQR, -1.5 to 4.5) in the sodium chloride group, with no significant difference between groups (P=0.810). Achievement of serum sodium ≥135 mEq/L was comparable between groups. Patient satisfaction scores were significantly higher in the protein supplementation group (P=0.001).
Conclusion
In outpatients with chronic SIAD, protein supplementation demonstrated comparable efficacy to sodium chloride tablets in increasing serum sodium concentration, with higher patient satisfaction. Larger studies are needed to further evaluate the role of protein supplementation in chronic SIAD.
Funding
- Private Foundation Support