RT Journal Article
SR Electronic
T1 Dysnatremia, vasopressin, atrial natriuretic peptide and mortality in community-acquired pneumonia – Results from the German competence network CAPNETZ
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 4711
VO 38
IS Suppl 55
A1 Stefan Krüger
A1 Jan Kunde
A1 Oliver Hartmann
A1 Norbert Suttorp
A1 Gernot Rohde
A1 Tobias Welte
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/4711.abstract
AB Background: Dysnatremia is frequent in pts with community acquired pneumonia (CAP). Associations between hyponatremia (HypoN), hypernatremia (HyperN) and other variables in CAP remain unclear.Methods: We enrolled 2138 pts (60±18 y, 45% f) with CAP. Pro-atrial natriuretic peptide (proANP), pro-vasopressin (proAVP), serum sodium (Na) and CRB-65 score were determined on admission. Patients were followed up for 28d. Na on admission was examined as a function of mortality at 28d. HypoN was defined as Na <136 mmol/L, HyperN as Na > 145 mmol/L.Results: HypoN was diagnosed in 680 (31.8%), HyperN in 29 (1.4%) pts. Pts with HypoN were older, had more comorbidities, higher CRB-65 and higher proAVP and proANP (all p< 0.05). When examined as a function of Na values, a U-shaped association was found between Na level and 28d mortality.In multivariate Cox proportional hazards analysis, HypoN and HyperN were independent predictors of 28d mortality. Those with HypoN and more elevated proAVP and proANP had highest rates of 28d death. HypoN predicted only 28d mortality in those with an elevated proAVP and proANP.Conclusion: HypoN is common in CAP and associated with mortality. HyperN is rare but also associated with mortality. However, the prognostic value of Na is mainly evident in those with more pronounced elevation of pro-vasopressin and proANP concentrations.