1 research outputs found
Impact of hyponatremia on frequency of complications in patients with decompensated liver cirrhosis
Introduction: Hyponatremia is common in cirrhosis. The relationship between hyponatremia and severity of
cirrhosis is evidenced by its close association with the occurrence of complications, the prevalence of hepatic
encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis, refectory ascites, and hepatic
hydrothorax. The aim of this study was assess the impact of hyponatremia on the occurrence of both liver-related
complications and the hemodynamic cardiovascular dysfunction.
Methods: This prospective study was conducted in 2015 on 74 patients with liver cirrhosis. The patients were\ud
from the Gastroenterology and Hepatology Department of Theodor Bilharz Research Institute in Giza, Egypt.
The patients were divided into three groups according to their serum level of sodium. Group 1 included 30
patients with serum sodium >135 meq/L, group 2 included 24 patients with serum sodium between135 and 125
meq/L, and group 3 included 20 patients with serum sodium <125 meq/L. For each of the patients, we conducted
aclinical examination, laboratory investigations, chest X-ray, ECG, abdominal sonar, and echocardiography.
Results: Hyponatremia was found in 59.46% of our cirrhotic patients, and they showed significantly increased
Model for End-Stage Liver Disease (MELD) score, MELD-Na score, QTc interval, Pulmonary vascular
resistance (PVR) and inferior vena cava (IVC) collapsibility, and decreased SVR and IVC diameter. Also hepatic
encephalopathy, ascites, renal failure, infectious complications, and pleural effusion were significantly more
common in hyponatremic cirrhotic patients.
Conclusion: In cirrhosis, hyponatremia is more common in severe cardiovascular dysfunction and associated
with increased risk of hepatic encephalopathy, ascites, illness severity scores, renal failure, infectious
complications, and pleural effusion. We recommend selective oral administration of vasopressin V2-receptor
antagonist, tolvaptan, which acts to increase the excretion of free water, thereby resolving hypervolemic
hyponatremia and may have the potential to improve outcomes in these patients