A 54-year-old man with chronic alcoholism is admitted for severe hyponatremia after several days of poor food intake while drinking large quantities of beer. Laboratory studies show sodium 118 mEq/L, serum osmolality 250 mOsm/kg, urine sodium 8 mEq/L, and urine osmolality 85 mOsm/kg. Which of the following is the most likely mechanism of his hyponatremia?

1. A)Severe hypertriglyceridemia causing pseudohyponatremia
2. B)Nephrogenic syndrome of inappropriate antidiuresis
3. C)Excess ADH secretion due to lung cancer
4. D)Low solute intake limiting free water excretionGABARITO
5. E)Primary adrenal insufficiency