DOI: https://dx.doi.org/10.18203/2349-3933.ijam20222395
Published: 2022-09-23

Dysnatremia in patients with chronic liver disease: a cross-sectional observational study

Ram Dev Chaudhary, Kirti Kumari Sah, Ram Prabodh Chaudhary

Abstract


Background: The clinical significance of serum sodium levels and its association with a higher rate of complications in cirrhosis is debatable. This study was done to study the serum sodium levels in chronic liver disease (CLD) patients and establish its association with the severity of disease in such patients.

Methods: In this cross-sectional study, we included adult patients diagnosed with CLD and assessed their serum electrolytes. The severity of liver disease was assessed using Child Pugh score (CPS) and model for end stage liver disease (MELD). Those with serum sodium levels less than 130 mEq/l were classified as group A, 131 to 135 mEq/l as normal group B and greater or equal to 136 mEq/l as Group C.

Results: In the present study, hepatic encephalopathy (p<0.01), hepatorenal syndrome (p<0.01) and coagulopathy (p<0.01) were found to occur significantly more common among patients from Group A, as compared to those in patients from group B or C. Mean MELD, CPS score and mortality was significantly higher among group A patients.

Conclusions: Patients with lower serum salt levels had a substantially higher MELD score and CPS. Low blood sodium levels were linked to more severe liver disease, greater complications, and increased death. As a result, we urge that serum salt levels be checked on a frequent basis in patients with chronic liver disease.

 


Keywords


Cirrhosis, Sodium, Hyponatremia, MELD, Prognosis

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References


Propst A, Propst T, Zangerl G, Ofner D, Judmaier G, Vogel W. Prognosis and life expectancy in chronic liver disease. Dig Dis Sci. 1995;40(8):1805-15.

James K S. India's demographic change: opportunities and challenges. Science. 2011;333(6042):576-80.

Ginés P, Berl T, Bernardi M, Bichet DG, Hamon G, Jiménez W et al. Hyponatremia in cirrhosis: from pathogenesis to treatment. Hepatology. 1998;28(3):851-64.

Prasanna Kumari K, Udayamma KP. Prevalence of Hyponatremia among patients admitted with Cirrhosis Liver and its Correlation with Hepatic Encephalopathy. 20015;1-2.

Cárdenas A, Ginès P. Predicting mortality in cirrhosis--serum sodium helps. N Engl J Med. 2008;359:1060- 2.

Child CG. Surgery and portal hypertension. The liver and portal hypertension. 1964:50-2.

Kamath PS, Weisner RH, Malinchoc M. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33:464-70.

Elkady MS, El-Toukhy NE, Rashed SE. Serum Sodium Concentration Profile in Cirrhotic Patients and its Effect on the Prognostic Value of the MELD Score. SAS J. Surg. 2016;2(6):266-77.

Kim JH, Lee JS, Lee SH, Bae WK, Kim NH, Kim KA et al The association between the serum sodium level and the severity of complications in liver cirrhosis. Kor J Internal Med. 2009;24(2):106.

Umemura T, Shibata S, Sekiguchi T, Kitabatake H, Nozawa Y, Okuhara S et al. Serum sodium concentration is associated with increased risk of mortality in patients with compensated liver cirrhosis. Hepatol Res. 2015;45(7):739-44.

Jenq CC, Tsai MH, Tian YC, Chang MY, Lin CY, Lien JM et al. Serum sodium predicts prognosis in critically ill cirrhotic patients. J Clin Gastroenterol. 2010;44(3):220-6.

Meganathan A, Kumar VS. Hyponatremia in cirrhosis- prevalence and correlation with the complications of cirrhosis. J Evol Med Dental Sci. 2018;7(18):2197-202.