Association of Hyponatremia and Encephalopathy in Patients with Chronic Liver Disease

Muhammad Akbar Memon,Abdul Salam Dal,Abdul Qadir,Nadeem Memom

doi:10.21649/akemu.v23i1.1499

Muhammad Akbar Memon, Abdul Salam Dal + Show 2 more

Open Access

https://doi.org/10.21649/akemu.v23i1.1499

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Abstract

Objective: To determine the association of hyponatremia in chronic liver disease patients with presentation of hepatic encephalopathy (HE) at Isra university Hospital Hyderabad.Methods: This study was cross sectional and carried out at medicine and gastroenterology department of Isra university Hospital Hyderabad and MMC Mirpurkhas. Study duration was from September 2015 to March 2016. All the cases with age more than 25 years, both genders after diagnosis of chronic liver disease with sign and symptoms of Hepatic Encephalopathy were selected in this study. Blood sample for serum sodium level, was send to diagnostic laboratory of the hospital. Hyponatremia was classified as: 130–135 mEqL (mild), 125–130 mEq/L (moderate) and &lt; 125 mEq/L (severe). Hepatic encephalopathy was categorized according to the West Haven classification (4 grades). Results: Total number of cases was 80. Mean age was 48 + 8.5 years. 55 (68.5%) patients were male. Majority of cases, 55 (68.5%) patients were infected with HCV. 40% patients had normal level of sodium, 25% had mild, 20% had moderate while 15% patients had severe hyponatremia. On the grading of encephalopathy, 30 (37.5%) patients had grade 1 encephalopathy while 25/(31.2%) patients had grade 2, 15/(18.8%) had grade 3 while 10 (12.5%) patients hade grade 4. The serum sodium levels significantly decreased with increasing severity of hepatic encephalopathy (P = 0.001).Conclusion: We concluded that the hyponatremia is significantly linked with Hepatic Encephalopathy (HE) in patients having chronic liver disease (CLD).

Highlights

Chronic liver diseases (CLD) and its complications are the major health problem, due to big burden of Hepatitis C virus and Hepatitis B virus in the community[1] and it is the commonest reason of death in Pakistani population
All the cases with age more than 25 years, both genders, after diagnosis of chronic liver disease with sign and symptoms of hepatic encephalopathy were selected in this study
According to classification of hyponatremia, majority of the patients had normal level of sodium, 25% had mild, 20% had moderate while 15% patients had severe hyponatremia (Fig. 1)

Summary

Introduction

Chronic liver diseases (CLD) and its complications are the major health problem, due to big burden of Hepatitis C virus and Hepatitis B virus in the community[1] and it is the commonest reason of death in Pakistani population. The clinical course of patients with CLD is frequently complicated due to increase in the renal function abnormalities and imbalance of electrolytes.[5]

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Results

Discussion

Conclusion