Hyponatremia As a Predicting Factor of Mortality in Chronic Liver Disease

Objective: To determine the worth of hyponatremia as a predicting factor of poor prognosis and mortality in chronic liver disease. Methodology: This retrospective cross-sectional study was carried out from January 2011 to January 2013 at Nishtar Hospital, Multan, Pakistan. All the continuous data including age, MELD score, MELD-Na score, albumin, creatinine, alanine transaminase, aspartate transaminase, gamma glutamyltransferase, total bilirubin level, serum chloride, platelet count, international normalized ratio were analyzed by applying Mann-Whitney U-test. All the nominal data were compared by Pearson Chi-square test. SPSS version 23 was used and p <0.05 was considered statistically significant. Results: Serum levels of alanine and aspartate transaminases (ALT & AST), gamma glutamyltransferase (GGT), total bilirubin and international normalized ratio (INR) were significantly low in the patients with serum sodium levels of >= 139mEq/L (p= 0.014, <0.001, <0.001, 0.001 and 0.018, respectively) but serum chloride was significantly higher (<0.001) in this group. Conclusion: The concentration of sodium in the serum less than 139 mEq/L and MELD-Na score of above 12 can be the predictive indicators of poor prognosis and mortality in the patients with chronic liver disease. Serum sodium levels need to be monitored vigilantly so that sudden development of complications of cirrhosis can be prevented.