Study the relation between serum sodium and the model for end-stage liver disease score in patients with liver cirrhosis

ObjectivesThe aim of the study was to evaluate the prevalence of hyponatremia in liver cirrhosis and the correlation between serum sodium and the Model for End-Stage Liver Disease (MELD) score in patients with liver cirrhosis.BackgroundHyponatremia (Na<135 mEq/l) is a common finding in advanced liver cirrhosis. Cirrhotic patients with hyponatremia have poor survival compared with cirrhotic normonatremic patients. There is an association between the presence of hyponatremia and the presence of certain liver cirrhosis complications such as hepatic encephalopathy, hepatorenal syndrome, and refractory ascites. Therefore, it was suggested that hyponatremia has a good predictive value of mortality in hepatic cirrhosis even with low MELD scores.Patients and methodsIn all, 100 patients with liver cirrhosis were enrolled in this study, 20% compensated and 80% decompensated. The decompensated group was subdivided into four subgroups according to the cause of admission.ResultsIn compensated cirrhosis the prevalence of hyponatremia was 0/20 (0%), whereas that in decompensated cirrhosis was 47/80 (59%). Also the prevalence of hyponatremia differed according to the complication itself, being highest in hepatorenal syndrome and hepatic encephalopathy (74 and 71%, respectively) and the lowest in variceal bleeding (45%). In decompensated cirrhosis, there was strong inverse correlation between serum sodium and MELD score (r = −0.496 and P < 0.001), whereas there was no significant correlation in compensated cirrhosis (r = −0.324 and P = 0.163).ConclusionThe importance of hyponatremia in advanced cirrhotic patients should not be overlooked because it may have a role in the prediction of survival in liver cirrhosis.