Moogaambiga, S (2016) Prospective Study of Hyponatremia in Decompensated Chronic Liver Disease and Its Correlation with Severity. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.
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Abstract
BACKGROUND: Dilutional hyponatremia associated with liver cirrhosis is caused by impaired free water clearance. Several studies have shown that serum sodium levels correlate with survival in cirrhotic patients. Low serum sodium concentration is an independent predictor of mortality in patients with cirrhosis, but its prevalence and clinical significance is unclear. The relationship between the degree of dilutional hyponatremia and development of cirrhotic complications has to be studied. The aim of this study was to study the prevalence of hyponatremia in cirrhosis and evaluate the association between the serum sodium level and the severity of complications in liver cirrhosis and its prognostic significance. AIMS AND OBJECTIVES: 1. To study the prevalence of hyponatremia in cirrhotic patients. 2. To study the association between hyponatremia and complications of cirrhosis and its correlation with severity of complications. METHODS: Data of patients with cirrhosis were collected prospectively. The prevalence and serum sodium levels and severity of complications of 100 patients were analyzed. RESULTS: The prevalence of dilutional hyponatremia, classified as serum sodium concentrations of < 135 meq/L and ≤ 130 meqL, were 31%, 21% respectively. The serum sodium level was strongly associated with the severity of liver function impairment as assessed by Child-Pugh and MELD scores (p < 0.001). Moreover, low serum sodium levels were also associated with greater frequency of hepatic encephalopathy (p value - < 0.001) and hepatorenal (p value - 0.003) syndrome. Patients with serum sodium < 130 meq/L had the greatest frequency of these complications, but the frequency was also increased in patients with mild reduction in serum sodium levels (131-135 meq/L). Patients with sodium ≤ 130meq/L had higher mortality rate (22.6%) compared to patients with serum sodium between 131-135meq/L (9.5%). There was no mortality in patients with normal sodium. CONCLUSIONS: Dilutional hyponatremia is frequent in cirrhotic patients and low serum sodium levels in cirrhosis are associated with severe complications of liver cirrhosis like hepatic encephalopathy, hepatorenal syndrome and high morbidity and mortality. Treatment of hyponatremia is important to prevent possible complications of liver cirrhosis.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.201311402 |
| Uncontrolled Keywords: | hyponatremia ; cirrhosis ; severity of complications ; hepatic encephalopathy. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 06 Feb 2019 00:27 |
| Last Modified: | 06 Feb 2019 00:27 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/10487 |
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