“A Study of Serum Sodium Levels in Decompensated Chronic Liver Disease and Its Correlation with the Severity of the Disease”

Abstract

Background: Decompensated Chronic Liver Disease (DCLD) is frequently associated with disturbances in water balance, leading to abnormalities in serum sodium levels. Hyponatremia, mainly dilutional, is common due to impaired free water clearance, while hypernatremia, though less frequent, has been linked to increased mortality. Several studies have demonstrated a correlation between serum sodium levels and survival in cirrhotic patients.

Aim: The study aims to assess serum sodium levels in patients with DCLD and establish their clinical significance in predicting disease severity and adverse outcomes.

Materials and Methods: This prospective descriptive cohort study was conducted over 18 months in a tertiary care hospital on 125 patients admitted with DCLD. Patients were evaluated based on clinical history, examination, laboratory investigations, and imaging. Serum sodium levels were recorded, and their association with complications, MELD score, and outcomes was analyzed. Data were statistically assessed using SPSS v23.0.

Results: The study population had a mean age of 50.11±10.22 years and was predominantly male (93.6%). Common clinical manifestations included ascites (100%), portal hypertension (96.8%), hepatic encephalopathy (8.8%), spontaneous bacterial peritonitis (13.6%), and hepatorenal syndrome (12.8%). A significant inverse correlation was observed between serum sodium levels and both MELD (r = -0.439, p < 0.05) and Child-Pugh scores                                  (r = -0.433, p < 0.05), indicating that mean sodium level 129 – 134mE/L were associated with greater disease severity. Hyponatremia was linked to adverse outcomes, with non-survivors exhibiting significantly lower sodium levels (125.58±8.2) compared to discharged patients (134.5±6.9) (p < 0.05).

Conclusion: Serum sodium levels are crucial in assessing the severity and prognosis of DCLD. Hyponatremia correlates with advanced liver dysfunction and increased mortality. Routine sodium assessment may aid in early risk stratification and management of patients with DCLD.