title: Relationship and interaction between serum sodium concentration and portal hemodynamics in patients with cirrhosis.
abstract: OBJECTIVE
  To examine the relationship between hyponatremia and portal hemodynamics and their effect on the prognosis of cirrhosis.
  
  
  METHODS
  Portal hemodynamic parameters measured by Doppler ultrasound and serum sodium concentrations were examined in 153 cirrhosis patients (mean age 62.2 ± 12.0 years; median observation period, 34.1 m).
  
  
  RESULTS
  Study participants included 16 patients with hyponatremia (Na < 135 mEq/L), who showed a significantly greater frequency of possessing a splenorenal shunt (SRS; P = 0.0068), and 137 patients without hyponatremia. Serum sodium concentrations were significantly lower in patients with SRS than in those without (P = 0.0193). An increased prothrombin time-international normalized ratio was a significant predictive factor for developing hyponatremia a year later (8/96; Hazard ratio 14.415; P = 0.028). The cumulative survival rate was significantly lower in patients with hyponatremia (46.7% at 1 and 3 years) than in those without (91.8% at 1 year, 76.8% at 3 years; P < 0.001). The cumulative survival rate was significantly lower in patients who had developed hyponatremia after 1 year (100% at 1 year, 62.5% at 3 years) than those who had not (100% at 1 year, 89.0% at 3 years; P < 0.001). The cumulative survival rate was significantly worse in patients with both hyponatremia and SRS (20% at 1 year).
  
  
  CONCLUSIONS
  There was a close linkage between the serum sodium concentration and portal hemodynamic abnormality, presence of SRS, and their interaction may negatively influence the prognoses in cirrhosis.
authors.affiliation: Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Maruyama
authors.affiliation: Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kiyono
authors.affiliation: Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Sekimoto
authors.affiliation: Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Okugawa
authors.affiliation: Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005544:Forecasting; D006439:Hemodynamics; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D019934:International Normalized Ratio; D008103:Liver Cirrhosis / Q000097:blood* / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology*; D011379:Prognosis; D011517:Prothrombin Time; D012964:Sodium / Q000097:blood*; D013164:Splenorenal Shunt, Surgical / Q000401:mortality; D015996:Survival Rate; D055815:Young Adult
chemical_list: D012964:Sodium
keywords: ascites; cirrhosis; hyponatremia; portal hypertension