Correlation of hyponatremia with hepatic encephalopathy and severity of liver disease.
OBJECTIVE
To assess the frequency of low serum sodium levels and to correlate it with the severity of liver disease and hepatic encephalopathy (HE) in patients coming to the tertiary care hospital.


METHODS
Observational study.


METHODS
Shifa International Hospital, Islamabad, from January 2011 to January 2012.


METHODS
A total of 202 patients with hepatic encephalopathy and chronic liver disease had serum sodium measured. The HE was graded according to the West Haven classification (4 grades). Relationship of hyponatremia was correlated with severity grade of encephalopathy using Spearman rank correlation test.


RESULTS
Out of 202 patients, 62 (30.7%) patients had serum sodium less than 130 meq/l. Out of 202, HE was present in 69 (34.15%) patients and out of these, 38 had grade III-IV HE and 31 had grade I - II HE. Out of 69 patients with HE 57 had sodium less than 135 (p < 0.001).


CONCLUSIONS
Hyponatremia was a common feature in patients with cirrhosis and its severity increased with the severity of liver disease. The existence of serum sodium concentration < 135 mmol/L was associated with greater frequency of hepatic encephalopathy compared with patients with serum sodium concentration > 135 mmol/L.
Department of Gastroenterology, Shifa International Hospital, Islamabad.
Muhammad Omar
MO
Qureshi
Department of Gastroenterology / Medicine, Shifa International Hospital, Islamabad.
Nasir
N
Khokhar
Department of Medicine, Shifa International Hospital, Islamabad.
Atif
A
Saleem
Department of Medicine, Shifa International Hospital, Islamabad.
Tariq Khan
TK
Niazi
D000328:Adult; D005260:Female; D006501:Hepatic Encephalopathy / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000453:epidemiology* / Q000378:metabolism; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood*; D018709:Statistics, Nonparametric
D012964:Sodium