title: Relationship between urinary fractional excretion of sodium and life prognosis in liver cirrhosis patients.
abstract: OBJECTIVE
  Renal vasoconstriction in generalized vasodilatation with blood pooling and the consequent reduction in effective arterial volume is the pathophysiological basis of liver cirrhosis (LC). Low levels of fractional excretion of sodium (FENa) are an effective marker of hypoperfusion of the renal artery. However, the relationship between levels of FENa, LC severity and life prognosis has not yet been elucidated.
  
  
  METHODS
  We examined 57 LC patients (39 men and 18 women; mean age, 70.5 ± 8.8 years; underlying liver disease, type B hepatitis in eight patients, type C hepatitis in 37, alcoholic hepatitis in four and others in eight) with renal dysfunction (estimated glomerular filtration rate (eGFR) <60 mL/min) who were admitted to our hospital.
  
  
  RESULTS
  Nine patients died because of uremia, liver failure, gastrointestinal bleeding and infection. No differences were found in patient background and blood pressure. However, in addition to differences in the levels of aspartate aminotransferase (AST), cholinesterase, albumin, prothrombin time (PT), eGFR and Model for End-Stage Liver Disease (MELD) score, the patients who died had significant differences in levels of FENa. The levels of FENa were significantly and inversely correlated with blood urea nitrogen, total bilirubin, AST, Child-Pugh score and MELD score, and were significantly and positively correlated with cholinesterase, albumin and PT. Moreover, the sensitivity (88%) and specificity (93%) of the levels of FENa of less than 0.4% to predict death were remarkably high.
  
  
  CONCLUSIONS
  Levels of FENa may reflect LC severity and may be associated with the life prognosis of LC patients.
authors: Internal Medicine 1, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors: Naro
authors: N
authors: Ohashi
authors: Naoko
authors: N
authors: Tsuji
authors: Yoshitaka
authors: Y
authors: Naito
authors: Takamasa
authors: T
authors: Iwakura
authors: Shinsuke
authors: S
authors: Isobe
authors: Masafumi
authors: M
authors: Ono
authors: Tomoyuki
authors: T
authors: Fujikura
authors: Takayuki
authors: T
authors: Tsuji
authors: Yukitoshi
authors: Y
authors: Sakao
authors: Hideo
authors: H
authors: Yasuda
authors: Kinya
authors: K
authors: Kawamura
authors: Takanori
authors: T
authors: Sakaguchi
authors: Akihiko
authors: A
authors: Kato
authors: Yoshihide
authors: Y
authors: Fujigaki
keywords: life prognosis; liver cirrhosis; urinary fractional excretion of sodium