HYPONATRAEMIA IN CIRRHOSIS- PREVALENCE AND CORRELATION WITH THE COMPLICATIONS OF CIRRHOSIS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 18
Abstract
BACKGROUND Hyponatraemia is one of the complications in cirrhotic patients, occurring in more than one-third of the patients with chronic liver disease and is believed to be caused by defective water homeostasis. The objective of our study is to establish the prevalence of hyponatraemia in cirrhosis and to investigate if hyponatraemia predicts a rate of severity of complications in cirrhosis. MATERIALS AND METHODS A cross-sectional study was done in patients diagnosed with cirrhosis by a combination of clinical, biochemical and radiological findings. Demographic data and biochemical parameters including serum sodium levels were recorded at the time of admission or at the time of presentation in the outpatient department and patients were stratified into three groups: Group A- serum sodium < 130 mmoL; Group B- serum sodium between 131 - 135 mmol/L; Group C- serum sodium > 136 mmol/L. A detailed case report proforma was used for data collection for each patient. RESULTS Hundred patients were included in the study. 44 patients had serum sodium level of < 130 mmol/L (Group A), 26 patients had serum sodium 131 - 135 mmol/L (Group B) and 30 patients noted to have serum sodium > 136 mmol/L (Group C). Majority of Group A patients belonged to 31 - 40 years of age (34%) and male gender (77%). Group A patients had rising serum bilirubin levels of 10.01 to 20 mg/dL (34%) compared to Group B and C (3.85% and 3.3% respectively). 84% of Group A patients had serum albumin < 3.5 g/dL. Blood urea levels > 40 mg/dL and serum creatinine > 1.3 mg/dL are associated with > 50% of Group A patients. 37 patients had worsening hepatic encephalopathy in Group A. 38% of Group A are associated with spontaneous bacterial peritonitis. 95% of Group A patients had portal hypertension compared to 65% of Group B and 11% of Group C. The incidence of class 3 Child-Turcotte Pugh score was significantly higher in Group A (70.28%). High MELD score (20 - 29) is associated with Group A patients (43.18%). CONCLUSION This study was undertaken to establish serum sodium as an independent variable in the prognosis of patients with decompensated liver disease, irrespective of the aetiology. MELD Na scores calculated using serum sodium values have been recently found to supersede MELD scores to determine prognosis. By comparing MELD vs. MELD Na scores, this study concludes that MELD Na scores have been found to be more significant as a prognostic marker in patients with cirrhosis and its complications.
Authors and Affiliations
Anusuya Meganathan, Santosh Kumar V
Keywords
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- EP ID EP417273
- DOI 10.14260/jemds/2018/494
- Views 73
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