Title: A Study on Hyponatremia in Decompensated Liver Disease
Authors: Antony David Devadas, Srividya, Ganesh Raja, Suresh Kumar, Sindhu, Shanmugasundaram, Manivel Ganesan
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.21
Abstract
Background: Chronic liver disease occurs throughout the world irrespective of age, sex, region or race. Cirrhosis is an end result of a variety of liver diseases characterized by fibrosis and architectural distortion of the liver with the formation of regenerative nodules and can have varied clinical manifestations and complications. Hyponatremia is a frequent complication of advanced cirrhosis related to impairment in the renal capacity to eliminate solute-free water, that causes retention of water which is disproportionate to the retention of sodium, thus causing a reduction in serum sodium concentration and hypo-osmolality. Hyponatremia in cirrhosis is associated with increased morbidity and mortality. There is evidence suggesting that hyponatremia may affect brain functions and predisposes to hepatic encephalopathy. Hyponatremia also represents a risk factor for liver transplantation as it is associated with increased frequency of complications and impaired short-term survival after transplantation.
Materials and Methods: This is a prospective study, conducted by Department of general medicine, Kanyakumari Government Medical College. The study period was from jan 2016 to jan 17. Informed consent obtained from the patients regarding the study.
Observation and Results: In this study, a total of 100 patients with decompensated liver disease were included. Among the 100 patients, 80 were males and 20 were females. Among this 67% of the patients were Alcoholics. 11 patients found to be HBsAg positive, 7 patients found to be Hep C Positive, 15 were cryptogenic. In this study, 70% of the patients were found to have hyponatraemia.
Conclusion: Hyponatremia is very common in patients with cirrhosisand the routine correction of asymptomatic hyponatremia is not recommended. The main indications for correction of hyponatremia are presence of neurologic symptoms that might be due to hyponatremia and serum sodium less than 120 mEq/L. Liver transplantation is the only definitive treatment for end stage liver diseases.
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