Which treatment is recommended for symptomatic euvolemic hyponatremia?

Fluid restriction is the recommended treatment for symptomatic euvolemic hyponatremia primarily because the underlying issue is often related to an excess of water retention rather than a deficiency of sodium. In euvolemic hyponatremia, the patient typically has normal volume status but low sodium levels, commonly due to conditions like the Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH).

Restricting fluid intake helps to correct the hyponatremia by decreasing the total body water, allowing the sodium concentration to rise back to normal levels. This approach is particularly effective because it addresses the dilutional aspect of hyponatremia without introducing additional sodium, which could exacerbate the problem.

While hypertonic saline can be used in certain severe or acute cases of hyponatremia, especially in an emergency situation where rapid correction of sodium levels is necessary, it is not typically the first-line treatment for symptomatic euvolemic hyponatremia. The use of intravenous calcium is unrelated to the management of hyponatremia, and oral hydration, while it may seem intuitive, would worsen the situation in cases where water retention is the problem. Therefore, fluid restriction stands out as the most appropriate