title: Mechanism of Hyponatremia in Community-Acquired Pneumonia: Does B-type Natriuretic Peptide Play a Causative Role?
abstract: OBJECTIVE
  Hyponatremia is a well-known sequela of community-acquired pneumonia (CAP). B-type natriuretic peptide (BNP) has a natriuretic effect and was found to be elevated in patients with CAP. We investigated whether BNP has a role in the pathophysiology of hyponatremia in pediatric CAP.
  
  
  METHODS
  Serum and urine electrolytes and osmolality, as well as NT-pro-BNP (N-BNP), were obtained in 49 hospitalized pediatric patients with CAP (29 with hyponatremia, 20 with normal sodium levels.
  
  
  RESULTS
  Urine sodium levels were lower in the hyponatremic group compared with the normonatremic group (24.3 meq/L vs 66.7 meq/L, P = 0.006). No difference in N-BNP levels was found between groups (median, 103.8 vs 100.1; P = 0.06; interquartile range, 63.7-263.3 pg/mL vs 47.4-146.4 pg/mL). N-BNP was not associated with serum or urinary sodium levels.
  
  
  CONCLUSIONS
  These results indicate that BNP is unlikely to play a causative role in the mechanism of hyponatremia in CAP.
authors.forename: Moran
authors.initials: M
authors.lastname: Hausman-Kedem
authors.forename: Shimon
authors.initials: S
authors.lastname: Reif
authors.forename: Dana
authors.initials: D
authors.lastname: Danino
authors.affiliation: Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Rona
authors.initials: R
authors.lastname: Limor
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Grinspan
authors.forename: Anat
authors.initials: A
authors.lastname: Yerushalmi-Feler
authors.forename: Amir
authors.initials: A
authors.lastname: Ben-Tov
authors.forename: Amir
authors.initials: A
authors.lastname: Birger
mesh_terms: D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000097:blood / Q000150:complications / Q000652:urine; D004573:Electrolytes / Q000097:blood / Q000652:urine; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000209:etiology* / Q000652:urine; D007223:Infant; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011014:Pneumonia / Q000097:blood / Q000150:complications* / Q000652:urine
chemical_list: D004573:Electrolytes; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain