1Associate Professor, Department of Medicine, G.R. Medical College, Gwalior
2Assistant Professor, Department of Medicine, G.R. Medical College, Gwalior
3Final Year PG Student, Department of Medicine, G.R. Medical College, Gwalior
4Assistant Professor, Department of PSM, SMIMS, Gangtok
*Corresponding author: Dr. Neelima Singh Assistant Professor, Department of Medicine, G.R. Medical College, Gwalior-4045929 Mob.no. 9977641964 Email: neelimajadon@yahoo.com
Online published on 4 January, 2017.
Hyponatremia is the most common electrolyte abnormality observed in hospitalized patients with cirrhosis of liver. Low serum sodium concentration is an independent predictor of mortality in patients with cirrhosis, but its prevalence and clinical significance is unclear.
1) The aim of the present study was to assess the frequency of low serum sodium in hospitalized patients with cirrhosis of liver.2)To study the correlation between the serum sodium levels and complications of cirrhosis.3) To assess the outcome in cirrhosis of liver with hyponatremia.
The study was conducted in 100 patients with cirrhosis of liver. All the patients diagnosed as cirrhosis of liver on the basis of clinical examination and imaging were included as subjects. Patients with Cardiac failure and Chronic kidney disease were excluded. The data was collected in a pre typed proforma. The patients demographics, clinical presentation and the severity of cirrhosis were assessed. Serum Sodium levels was done in all the patients and the values correlated with various complications of cirrhosis and outcome. Serum sodium less than 135 meq/Lwas considered as hyponatremia. The enrolled patients were followed up during hospital stay and the outcome at the time of discharge noted.
This prospective study included 100 patients out of which 76 were males and 24 females. 88%(88) cases were between 20–60 years. Prevalence of hyponatremia was 46%. Hepatic encephalopathy was observed to be highly significantly associated with low serum sodium levels. 22 (84.6%) and 4 (15.4%) patients with hyponatremia and normal sodium levels respectively had encephalopathy. P value-<0.001. 5 (83.3%) patients with hepatorenal syndrome had hyponatremia and 1 (16.7%) patient with hepatorenal syndrome (HRS) had normal sodium levels. Hepatorenal syndrome also showed significant relationship with hyponatremia. P value< 0.05. Overall mortality was11 (11%).10 (90.9%) patients amongst those who expired had hyponatremia. Pvalue =0.002
Hyponatraemia is frequent in cirrhotic patients. Serum sodium levels should be closely monitored in patients experiencing complications of cirrhosis. Low serum sodium levels in cirrhosis are associated with high frequency of hepatic encephalopathy and hepatorenal syndrome with high morbidity and mortality.
Cirrhosis, Complications, Hyponatremia
