European Journal of Cardiovascular Medicine

Introduction: Hyponatremia is serum sodium less than 135 meq/lit. Hyponatremia is the most common electrolyte disorder in hospitalised patients. In advanced cirrhosis a disturbance of body water homeostasis is a common feature. Hence there is higher rate of renal retention of water in relation to sodium due to a reduction in solute-free water clearance. Pathologic features consist of the development of fibrosis to the point that there is architectural distortion with the formation of regenerative nodules. This results in a decrease in hepatocellular mass, and thus function, and an alteration of blood flow. The induction of fibrosis occurs with activation of hepatic stellate cells, resulting in the formation of increased amounts of collagen and other components of the extracellular matrix.Material And Methods: This is cross-sectional study conducted in the Department of General Medicine at Mahalakshmi Multispeciality Hospital, Ambattur, Chennai from June 2021 to May 2023. Patients were selected based on clinical examination, biochemical tests and ultrasound abdomen. Informed consent was obtained from all patients enrolled for the study. The data of the patients like relevant clinical history, examination findings, laboratory investigations were recorded in a proforma sheet. All the patients enrolled in the study were examined at the time of admission in the hospital and their serum sodium levels were checked and the patients were followed during their stay in the hospital. The severity of cirrhosis was assessed according to Child-Pugh score. MELD score and MELD-Na score were also calculated at the time of admission. Results: The mean age of the patients was 48.15±13.79 and consisted of 85 (94.4%) men and 05 (5.6%) women. Causative factors for liver cirrhosis included alcoholism in 90% of patients, hepatitis B in 5.6% of patients and hepatitis C in 4.4% of the patients. Alcohol was the most common etiology in present study, seen in 94.4% patients.In the present study, alcohol is found to be cause of cirrhosis in 24 patients out of 25 (96%) in the group with serum sodium levels ≤ 130 meq/L, in 23 patients out of 28 (82%) in patients with serum sodium levels between 131-135 meq/L, in 33 out of 37 patients (89.2%) in the group with serum sodium levels ≥136 meq/L. In the present study, there is no significant statistical differencebetween the three groups with respect to alcohol as the cause of cirrhosis (p value 0.25). Conclusions: Dilutional hyponatremia is frequent in cirrhotic patients and low serum sodium levels are associated with severe complications of liver cirrhosis like hepatic encephalopathy, hepatorenal syndrome. Hyponatremia is also associated with high morbidity and mortality in cirrhotic patients. Hence hyponatremia is a valuable marker that can be used to assess the prognosis in patients with cirrhosis of liver. Incorporation of sodium levels in MELD score is much more useful than MELD score alone to assess the prognosis and to refer the patient for liver transplantation.