Clinical Significance of Serum Sodium Levels in Liver Cirrhosis: A Cross-sectional Observational Study

Abstract

Introduction: Hyponatremia is a dominant feature and is of primary concern in liver cirrhosis. It is an important prognostic factor for the severity and complications of liver cirrhosis associated with poor survival. The issue of hyponatremia in liver cirrhosis has been the subject of intense debate within the scientific community. Aim: To determine the association of serum sodium levels with the severity and complications of liver cirrhosis. Materials and Methods: This observational, cross-sectional study included all adult patients diagnosed with liver cirrhosis, admitted in single tertiary care centre from December 2016 to April 2018. Their serum sodium levels was estimated on admission and correlated with Child Pugh Score and complications of cirrhosis. Statistical analysis was done by Chi-Square test, Fisher’s-exact test and Odds Ratio (OR) estimation. Results: A total of 95 patients were enrolled in the study. Majority were in the age group of 41-50 years (35.8%) with a mean age of 48.38±11.8 (mean±SD). There was a male preponderance (91 patients, 96.8%). Hyponatremia (≤130 meq/L) was noted in 33 patients (34.7%). Among the patients with hyponatremia, 29 (87.9%) belonged to Child Pugh C. The association of hyponatremia with Child Pugh C was highly significant (OR 3.987; CI 1.240-12.818; p=0.029). A positive correlation was found between low sodium levels (≤130 meq/L) and complications such as spontaneous bacterial peritonitis (OR 4.667; CI 1.538-14.164; p=0.004) and hepatorenal syndrome (OR 5.357; CI 0.979-29.327; p=0.034). Conclusion: Low sodium levels in cirrhosis has a positive correlation with the disease severity, hepatorenal syndrome and spontaneous bacterial peritonitis.