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RecruitingNCT06821802TREASURExUpdated Jul 10, 2025

Protein Supplementation in Hyponatremia Due to the Syndrome of Inappropriate Antidiuresis

An interventional study of Moltein PURE Protein Powder and Fluid restriction in Hyponatremia and Syndrome of Inappropriate Antidiuresis, sponsored by University Hospital, Basel, Switzerland. Recruiting at 1 site in Switzerland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-07-10.

Sponsored by University Hospital, Basel, Switzerland · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Apr 2025; still recruiting 1 year 6 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
70
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this study is to assess the impact of protein supplementation on hyponatremia caused by the syndrome of inappropriate antidiuresis during hospitalization.

Read the detailed description

Hyponatremia (plasma sodium \<135 mmol/L) is the most common electrolyte disorder, affecting up to 30% of hospitalized patients. Chronic hyponatremia (>48 hours) is linked to longer hospital stays, higher costs, increased mortality, and morbidity (e.g., falls, fractures, cognitive deficits). The most common cause of euvolemic hyponatremia is syndrome of inappropriate antidiuresis (SIAD), characterized by excessive water retention due to dysregulated vasopressin activity. Treatment options include fluid restriction or increasing water excretion with AVP antagonists, SGLT2 inhibitors, or oral urea.

A recent trial showed that protein supplementation can induce osmotic diuresis and raise sodium levels similarly to oral urea, with better tolerability. Since protein supplementation is often used in hospitalized patients with malnutrition, this study aims to compare its acceptability to fluid restriction in hospitalized SIAD patients. This head-to-head superiority trial will randomize patients to receive either 80 g of dietary protein daily or fluid restriction (1000 mL/day) for up to 5 days. The hypothesis is that protein supplementation is significantly more acceptable to patients than fluid restriction, ultimately improving treatment outcomes.

02

Conditions studied

  • Hyponatremia
  • Syndrome of Inappropriate Antidiuresis

Keywords

  • dysregulated arginine vasopressin (AVP) secretion
  • increased renal AVP sensitivity
  • protein supplementation
  • fluid restriction
03

In context

Hyponatremia

164 studies on the registry are indexed under Hyponatremia; 16 are open to participants now.

This study's planned enrollment of 70 is above the median of 60 across 98 interventional studies indexed under Hyponatremia.

Browse Hyponatremia studies →

Lead sponsor

University Hospital, Basel, Switzerland is the lead sponsor of 990 studies on the registry; 189 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Adult patients with confirmed SIAD during the hospital stay or at screening, defined by:
  • Plasma sodium concentration \<135 mmol/L
  • Plasma osmolality \<300 mOsm/kg
  • Urine osmolality >100 mOsm/kg
  • Urine sodium concentration >30 mmol/L
  • Clinical euvolemia (no signs of hypovolemia or hypervolemia)

Exclusion criteria

Exclusion Criteria:

  • Lactose intolerance, milk protein allergy, soy allergy, nuts allergy, or to components of the protein supplement.
  • Inborn metabolic disorders affecting carbohydrate, lipid, or protein metabolism.
  • Severe symptomatic hyponatremia requiring 3% NaCl or intensive care.
  • New (within the last five days) treatment with SGLT2 inhibitors, vaptans or oral urea
  • Uncontrolled severe hypothyroidism (untreated)
  • Uncontrolled adrenal insufficiency (morning cortisol \<150nmol/l)
  • \<45 mL/min/1.73 m² (KDIGO G3b-5) or end-stage renal disease (dialysis)
  • Severe hepatic impairment or advanced symptomatic liver disease defined as past or current hepatic encephalopathy, liver cirrhosis Child C, or decompensated (bleeding, jaundice, hepatorenal syndrome)
  • Pregnancy, breastfeeding, or plans to become pregnant during the study.
  • End-of-life care
  • Lack of capacity or other reasons preventing from giving or following study procedures (e.g., due to language problems, psychological disorders, dementia, etc.)
  • Treatment with thiazid diuretic (must be stopped at least 48 hours before inclusion)

Post-randomization Exclusion Criteria:

  • Type 1 diabetes or uncontrolled type 2 diabetes ( >8.0%)
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
70 participants (estimated)

Study arms

  • Experimental
    Protein Supplementation

    80 g protein supplementation per day (two bottles, each containing 40 g protein)

    Dietary Supplement: Moltein PURE Protein Powder

  • Active comparator
    Fluid restriction

    total daily fluid intake to a maximum of 1000 ml

    Behavioral: Fluid restriction

Interventions

  • Dietary supplementMoltein PURE Protein Powder

    80 g protein supplementation per day (two bottles, each containing 40 g protein)

  • BehavioralFluid restriction

    total daily fluid intake to a maximum of 1000 ml

06

What researchers measure

Primary outcomes

  1. Acceptability of Intervention Measure (AIM) questionnaire

    Treatment acceptability is assessed using the Acceptability of Intervention Measure (AIM) questionnaire, a validated patient-reported outcome measure scored on a 1 to 5 Likert scale. The total AIM score ranges from 4 to 20, with higher scores indicating greater acceptability. The primary analysis will compare AIM scores between the two treatment groups at the end of the intervention (day 5 or discharge).

    Time frame: On day 5 (or discharge)

Secondary outcomes

  1. Plasma sodium levels

    Change in change in plasma sodium levels in mmol/l will be assessed at study inclusion to day 5 of treatment or until discharge

    Time frame: Daily measurements from the day of inclusion to day 5

  2. Estimated glomerular filtration rate (eGFR)

    Assessement of creatinine levels

    Time frame: On the day of inclusion and on day 5

  3. Changes in blood electrolytes

    Assessement of sodium levels

    Time frame: On the day of inclusion and on day 5

  4. Changes in urine electrolytes

    Assessement of sodium levels

    Time frame: On the day of inclusion and on day 5

  5. Changes in glucose levels

    Assessement of glucose levels

    Time frame: On the day of inclusion and on day 5

  6. Changes kidney parameters

    Assessement of urea and uric acid levels

    Time frame: On the day of inclusion and on day 5

  7. Plasma sodium levels one day after treatment start

    Plasma sodium levels 12-36 hours after treatment start in patients with a plasma sodium concentration \<125 mmol/L at baseline.

    Time frame: On the day of inclusion and 12-36 hours after treatment initiation

  8. Endocrine parameters

    Blood levels of copeptin, aldosterone, renin, MR-proANP and NT-proBNP, apelin, etc. are assessed

    Time frame: On the day of inclusion and on day 5

  9. General well-being

    General well-being measured by numerical rating scale (NRS). Score from 0-10 while 10 indicates improved well-being

    Time frame: On the day of inclusion and on day 5

  10. Symptoms of hyponatremia

    Symptoms of hyponatremia (e.g. vertigo, headache, nausea, attention deficit, mental slowness, forgetfulness, gait instability) assessed by a questionnaire (yes/no; if yes: VAS, 0-10).

    Time frame: On the day of inclusion and on day 5

  11. Fluid intake

    Oral daily fluid intake assessed using a self-completed drinking protocol.

    Time frame: Daily measurements from the day of inclusion to day 5

  12. Changes in body weight

    Body weight is assessed

    Time frame: On the day of inclusion and on day 5

  13. Changes in blood pressure

    Systolic and diastolic blood pressure will be measured

    Time frame: On the day of inclusion and on day 5

  14. Changes in heart rate

    Heart rate will be assessed

    Time frame: On the day of inclusion and on day 5

  15. Differences in clinical outcomes - length of hospital stays

    Length of hospital stays will be assessed

    Time frame: Daily from the day of inclusion to day 5

  16. Need for additional hyponatremia treatment and treatment escalation

    Assessment of treatment escalation (YES/NO) including: A: administration of 3% NaCl infusion; B: administration of oral urea; C administration of SGLT2 inhibitors; D: administration of vaptans; E: administration of diuretics; F: other during the treatment period.

    Time frame: Daily from the day of inclusion to day 5

  17. Treatment compliance

    The participant's daily consumption of protein drinks and/or their adherence to a fluid restriction regimen is recorded.

    Time frame: Daily from the day of inclusion to day 5

  18. Quality of life (EQ-5D-5L) questionnaire

    Participants' health-related quality of life is assessed using the EuroQol 5 Dimensions, 5 Levels (EQ-5D-5L) questionnaire. , which includes five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension is rated on five levels, ranging from no problems to extreme problems.

    Time frame: On the day of inclusion and on day 5

07

Study locations

1 of 1 sites recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 10, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06821802
Responsible party
Sponsor
First posted
Feb 12, 2025
Start date
Apr 14, 2025
Primary completion
Apr 2027 (estimated)
Completion
Apr 2027 (estimated)
Last update
Jul 10, 2025

Study contacts

Mirjam Christ-Crain, Prof. MD
Contact
mirjam.christ-crain@usb.ch
+41 61 328 70 80
Cemile Bathelt
Contact
cemile.bathelt@usb.ch
+41 61 556 54 07
Mirjam Christ-Crain, Prof. MD
principal investigator · Universitätsspital Basel

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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