title: Hepatic venous pressure gradient can predict the development of hepatocellular carcinoma and hyponatremia in decompensated alcoholic cirrhosis.
abstract: OBJECTIVE
  Portal hypertension is closely associated with serious complications of cirrhosis, which contribute to bad prognosis. Hepatocellular carcinoma (HCC) and low serum sodium (SNa) are manifestations of end-stage liver disease and are associated with poor survival in decompensated cirrhosis patients. We aimed to determine the relationship between hepatic venous pressure gradient (HVPG) and the development of HCC or low SNa in decompensated alcoholic cirrhosis patients.
  
  
  METHODS
  Child-Pugh scores, Model for End-Stage Liver Disease scores, and HVPG at baseline, and the development of HCC or low SNa (SNa <130 mEq/l) during follow-up were analyzed prospectively in 170 patients with decompensated alcoholic cirrhosis from December 1999 to January 2008 (mean follow-up period of 33.9+/-27.9 months). The predictive value of different risk factors for the development of HCC and low SNa and survival were investigated.
  
  
  RESULTS
  Twenty-four patients developed HCC during the follow-up period. In the multivariate analysis, only baseline HVPG greater than 15 mmHg was an independent predictive factor for the development of HCC (relative risk=1.128, P<0.05) and which showed a significantly shorter time for the development of HCC on the Kaplan-Meier analysis. Twenty patients developed low SNa during follow-up. Initial HVPG was also an independent predictive factor for the new development of low SNa in the multivariate analysis (relative risk=1.169, P<0.05) and which also showed significantly shorter times for the development of low SNa on the Kaplan-Meier analysis.
  
  
  CONCLUSIONS
  In decompensated alcoholic cirrhosis, HVPG may be a useful predictive factor for the development of HCC and low SNa.
authors.affiliation: Departments of Internal Medicine and Institute of Lifelong Health, Yonsei University Wonju College of Medicine, 162 Ilsan-dong, Wonju, South Korea.
authors.forename: Moon Young
authors.initials: MY
authors.lastname: Kim
authors.forename: Soon Koo
authors.initials: SK
authors.lastname: Baik
authors.forename: Chang Jin
authors.initials: CJ
authors.lastname: Yea
authors.forename: Il Young
authors.initials: IY
authors.lastname: Lee
authors.forename: Hye Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Kyong Won
authors.initials: KW
authors.lastname: Park
authors.forename: Hearn Kook
authors.initials: HK
authors.lastname: Kim
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Suk
authors.forename: Jae Woo
authors.initials: JW
authors.lastname: Kim
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sang Ok
authors.initials: SO
authors.lastname: Kwon
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Cha
authors.forename: Young Ju
authors.initials: YJ
authors.lastname: Kim
authors.forename: Sang Baek
authors.initials: SB
authors.lastname: Koh
authors.forename: Sei Jin
authors.initials: SJ
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006503:Hepatic Veins / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000503:physiopathology; D007010:Hyponatremia / Q000209:etiology*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications* / Q000503:physiopathology; D008113:Liver Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D014690:Venous Pressure / Q000502:physiology