Abstract
Hyponatremia is an electrolyte imbalance encountered in patients with end-stage liver disease. It occur in about 57% of hospitalized patients with cirrhosis. Hyponatremia in cirrhosis is an independent risk factor for mortality and is common in patients with end-stage liver disease. These patients had a significantly higher incidence of hepatic encephalopathy, hepatorenal syndrome, and spontaneous bacterial peritonitis. Hepatic encephalopathy is worsened by the presence of hyponatremia. Hyponatremia can induce or aggravate HE, leading to disease progression and even death.
Aim: To study the Prevalence of Hyponatremia among Patients admitted with Cirrhosis liver and its correlation with Hepatic Encephalopathy.
Materials and Methods: It is an observational Study of one year duration conducted among 120 patients with cirrhosis admitted in General Medicine and Medical Gastroenterology in a tertiary care centre in south kerala. Data collected and analyzed using SPSS Software.
Conclusions: Among the 120 cases enrolled in the study, majority were males. 36 % of the patients belonged to age group 51 -60 years with mean age 53.28 (SD -9.64).The prevalence of hyponatremia was 59% .There is a positive correlation between hyponatremia and hepatic encephalopathy.(p value 0.001). More patients with severe hyponatremia belonged to Child- Pugh class C. The patients with hyponatremia and hepatic encephalopathy had poor prognosis.
Keywords: Hyponatremia; Cirrhosis, Hepatic encephalopathy, Prevalence.
References
- Angeli P, Wong F, Watson H, et al. CAPPS Investigators. Hyponatremia in cirrhosis: Results of a patient population survey. Hepatology. 2006;44:1535-42
- Harrison, Tinsley Randolph et al. Harrison's Principles Of Internal Medicine. 19th ed. New York: McGraw Hill Education, 2015. Print.
- Ahluwalia V, Wade JB, Thacker L, et al. Differential impact of hyponatremia and hepatic encephalopathy on health-related quality of life and brain metabolite abnormalities in cirrhosis. J Hepatol. 2013;59:467-73
- Biggins SW, Rodriguez HJ, Bacchetti P, et al. Serum sodium predicts mortality in patients listed for liver transplantation. Hepatology. 2005;41:32-39.
- European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53:397-417.
- Bustamante J, Rimola A, Ventura PJ, et al: Prognostic significance of hepatic encephalopathy in patients with cirrhosis. J Hepatol 1999; 30:890-5.
- Guevara M, Baccaro ME, Torre A, et al. Hyponatremia is a risk factor of hepatic encephalopathy in patients with cirrhosis: a prospective study with timedependent analysis. Am J Gastroenterol. 2009;104: 1382-89.
- Borroni G, Maggi A, Sangiovanni A, Cazzaniga M, Salerno F. Clinical relevance of hyponatremia for the hospital outcome of cirrhotic patients. Dig Liver Dis 2000; 32:605-10.
- Qureshi MO, Khokhar N, Saleem A, Niazi TK. Correlation of hyponatremia with hepatic encephalopathy and severity of liver disease. J Coll Physicians Surg Pak. 2014;24(2):135-137.
- Akbar, A., Jaffery, M.H., Memon, M.A., Arwani, S., Memon, H.N.A. and Shah, S.Z.A., 2015. LIVER CIRRHOSIS; FREQUENCY AND SEVERITY OF HYPONATREMIA IN PATIENTS. Professional Medical Journal, 22(4).
- D'Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. Journal of hepatology. 2006 Jan 1;44(1):217-31.
Corresponding Author
Dr Udayamma.K.P
Associate Professor of Medicine,
Govt.TD Medical College Vandanam PO, Alappuzha 688005
Mobile: 9447794377, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.