From the Guidelines

Mild hyponatremia (Na 126-135 mEq/L) does not require specific management apart from monitoring and water restriction.

The goal is to correct serum sodium levels while preventing overcorrection, which can lead to central pontine myelinolysis (CPM) or other complications 1.
Water restriction is a key component of treatment, with a recommended intake of 1,000 mL/day for moderate hyponatremia and more severe restriction for severe hyponatremia 1.
Discontinuation of diuretics may be necessary, especially if they are contributing to hypovolemic hyponatremia 1.
Hypertonic saline is typically reserved for short-term treatment of patients with symptomatic or severe hyponatremia, or those with imminent liver transplant 1.
Vasopressin receptor antagonists may be considered for short-term use in patients with severe hyponatremia, but their use should be cautious and limited to ≤30 days 1.
Albumin infusion may be effective in improving serum sodium concentration, but more information is needed to fully understand its role in treatment 1.

The rate of correction of serum sodium should not exceed 8 mEq/L per 24-hour period to minimize the risk of CPM 1.
Patients with liver cirrhosis and ascites require careful management, as hyponatremia is associated with a poor prognosis and multiple complications 1.
Treatment should be individualized based on the underlying cause of hyponatremia, the severity of symptoms, and the patient's overall clinical condition 1.

From the Research

The treatment for mild hyponatremia (low sodium levels) depends on the underlying cause and the patient's fluid volume status.

For asymptomatic mild hyponatremia, an adequate solute intake with an initial fluid restriction (FR) of 500 ml/day adjusted according to the serum sodium (sNa) levels is preferred 2.
In patients with the syndrome of inappropriate antidiuretic hormone (SIADH), urea and tolvaptan are considered the most effective second-line therapies 2.
Oral urea is considered to be a very effective and safe treatment for mild and asymptomatic hyponatraemia 2.
Specific treatment with vaptans may be considered in either euvolaemic or hypervolaemic patients with high ADH activity 2.

The approach to managing hyponatremia should consist of treating the underlying cause 3.

For most patients, the approach to managing hyponatremia should consist of treating the underlying cause, and urea and vaptans can be effective treatments for the syndrome of inappropriate antidiuresis and hyponatremia in patients with heart failure 3.
However, urea and vaptans have adverse effects, such as poor palatability and gastric intolerance with urea, and overly rapid correction of hyponatremia and increased thirst with vaptans 3.

The correction of hyponatremia should be done gradually to avoid osmotic demyelination, a rare but severe neurological condition 4, 5.

A 4-6 mEq/l increase in serum sodium is sufficient to reverse impending herniation in acute hyponatremia 4.
In chronic hyponatremia, correction should not exceed 8 mEq/l/day, and in high-risk patients, correction should not exceed 4-6 mEq/l/day 4.
Planning therapy to achieve a 6 mEq/l daily increase in the serum sodium concentration can avoid iatrogenic brain damage by staying well clear of correction rates that are harmful 5.