Prevalence of hyponatremia in Cirrhosis and its correlation with severity of the disease

Background and aims: Clinical manifestations of cirrhosis result from pathophysiological changes and also reflect the severity of the disease regardless the etiology. Portal hypertension is a major complication of cirrhosis which leads to development of ascites and esophageal varices.1 Method: 232 cirrhotic patients were included in this study from November 2017 to December 2018. Hyponatremia was defined as serum sodium level <135mEq/L and was classified as severe, moderate and mild. Disease severity was described using Child-Pugh Score (CPS) and Model for End-Stage Liver Disease (MELD) score. Association between categorical variables were tested using the Chisquare test. Correlation between variables was assessed using the Pearson correlation coefficient. Statistical analysis was performed with IBM SPSS Statistics version 21 Software. A p-value less than or equal to 0.05 was considered significant. Results: Out of 232 patients 33.62% (n=78) had normal sodium levels while 154 patients had hyponatremia among whom 19% (n=46), 15.52%, (n=36), 31.62 % (n=72) patients had severe, moderate and mild hyponatremia respectively. Sodium level was negatively correlated (r= -0.254) with MELD score (p <0.0). The majority of the patients had hyponatremia in CPS class C, followed by Class B and Class A in different hyponatremia groups. Conclusion: Hyponatremia is a prevalent finding in Cirrhosis of the liver, especially in an advanced stage. The severity of hyponatremia correlates with the severity of liver disease and complications in the majority of the cases.

Keywords: Cirrhosis, Hyponatremia, Disease severity, Child-Pugh Score, MELD Score