STUDY OF HYPONATREMIA AND ITS OUTCOME IN CIRRHOSIS OF LIVER

Background: Hyponatremia in cirrhosis is currently defined as a serum sodium level of less than 130 meq/L. Recent studies have reported that lower serum sodium levels are associated with increased complications and mortality leading to incorporation of sodium in the MODEL FOR END STAGE LIVER DISEASE. Aim: To study serum sodium levels in patients admitted with cirrhosis of liver and its outcome. Materials and Methods: A hospital based survey was conducted on 100 patients of liver cirrhosis for period of 18 months. The status of the patients at the time of inclusion as well as severity of cirrhosis was assessed using Child-Pugh score and Model for End Stage Liver Disease (MELD) Score. Results: Based on the serum sodium levels, 34% of patients had serum sodium levels less than or equal to 130. Grade 1 hepatic encephalopathy prevalence was 72.7% in sodium<130., grade 2 hepatic encephalopathy prevalence 38.9%,and grade 3 hepatic encephalopathy 57.1%.Similarly,the prevalence of SBP in the hyponatremia group is 63.6% ( p value =0.004). The prevalance of coagulopathy is 44.4% among hyponatremia group (p value =0.003). The mean CHILD PUGH SCORE in the sodium group less than or equal to 130 was high compared to sodium more than 135 High MELD score was seen in patients with sodium less than 130. All these differences are statistically significant (p value <=0.001) Conclusion: Patients with decreased serum sodium levels should be considered a high risk population because of the increased frequency of complications and mortality.