PMID- 16607534
OWN - NLM
STAT- MEDLINE
DCOM- 20070126
LR  - 20211020
IS  - 0256-7040 (Print)
IS  - 0256-7040 (Linking)
VI  - 22
IP  - 10
DP  - 2006 Oct
TI  - Diagnosis and management of cerebral salt wasting (CSW) in children: the role of 
      atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP).
PG  - 1275-81
AB  - OBJECTIVE: The aim of this study is to report our experience with diagnosis and 
      management of cerebral salt wasting (CSW) in children and to evaluate the role of 
      atrial natriuretic peptide/brain natriuretic peptide (ANP/BNP) in pediatric 
      patients. MATERIALS AND METHODS: We present nine children suffering from 
      prevalent cerebral disease--seven of whom underwent anesthesia and surgical 
      procedures--with features of CSW, seen within a 22-month period. The symptoms, 
      patient characteristics (including hormone status), monitoring, treatment 
      protocol, and outcome are described. RESULTS: Natriuresis (urine Na+ 
      concentrations 131 to >250 mmol/l) and polyuria (5.5+/-1.5 ml/kg/h) with 
      increased Na+ turnover (maximum Na+ loss: median 1.50 mmol Na+/kg/h, range 0.47 
      to >3.50) vanished within 2 weeks in 6/9 patients (increase in serum Na+ from 
      127+/-2 mmol/l to 136+/-1). K+ excretion was also high (maximum K+ loss: median 
      0.18 mmol K+/kg/h, range 0.09-0.53). ANP/BNP as suspected causes of salt wasting 
      were elevated only in 1/6 and 2/7 patients, respectively. Plasma renin activities 
      and aldosterone levels were either suppressed or in the low normal range. 
      CONCLUSION: Natriuresis and polyuria are the main diagnostic criteria for CSW. 
      The fluid balance in CSW is negative, in contrast to a positive fluid balance in 
      SIADH. The length of the disease is self-limited and generally ceases within 2 
      weeks, while Na+, K+, and fluid turnover should be monitored carefully. Only a 
      minority of our children showed elevated ANP/BNP levels. A dose/effect 
      relationship for natriuretic peptide levels and increased Na+ turnover could not 
      be established.
FAU - von Bismarck, Philipp
AU  - von Bismarck P
AD  - Department of General Pediatrics, Children's Hospital, Universitatsklinikum 
      Schleswig-Holstein, Campus Kiel, Schwanenweg 20, 24105, Kiel, Germany.
FAU - Ankermann, Tobias
AU  - Ankermann T
FAU - Eggert, Paul
AU  - Eggert P
FAU - Claviez, Alexander
AU  - Claviez A
FAU - Fritsch, Michael J
AU  - Fritsch MJ
FAU - Krause, Martin F
AU  - Krause MF
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20060411
PL  - Germany
TA  - Childs Nerv Syst
JT  - Child's nervous system : ChNS : official journal of the International Society for 
      Pediatric Neurosurgery
JID - 8503227
RN  - 0 (Salts)
RN  - 11000-17-2 (Vasopressins)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
SB  - IM
MH  - Adolescent
MH  - Atrial Natriuretic Factor/*metabolism
MH  - Brain Diseases/*diagnosis/*metabolism
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - Natriuretic Peptide, Brain/*metabolism
MH  - Radioimmunoassay/methods
MH  - Salts/administration & dosage/*metabolism
MH  - Time Factors
MH  - Vasopressins/metabolism
EDAT- 2006/04/12 09:00
MHDA- 2007/01/27 09:00
CRDT- 2006/04/12 09:00
PHST- 2005/09/26 00:00 [received]
PHST- 2006/04/12 09:00 [pubmed]
PHST- 2007/01/27 09:00 [medline]
PHST- 2006/04/12 09:00 [entrez]
AID - 10.1007/s00381-006-0091-x [doi]
PST - ppublish
SO  - Childs Nerv Syst. 2006 Oct;22(10):1275-81. doi: 10.1007/s00381-006-0091-x. Epub 
      2006 Apr 11.