Assessing Serum Sodium Levels in Chronic Liver Disease (CLD) Patients and Determining the Association with the Severity and Outcome of Disease: An Observational Comparative Study

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Abstract (English)

Abstract
Aim: This study was done to study the serum sodium levels in chronic liver disease (CLD) patients and
establish its association with the severity of disease in such patients.
Material & Methods: An observational cross-sectional study with 200 cases of chronic liver disease was done
in the Department of General Medicine for 2 years.
Results: All patients had abdominal distension. It was observed that patients from group A had jaundice
(p<0.05) and altered sensorium (p<0.001) significantly more commonly as compared to those from group B and
C. Alcohol consumption was reported by 88.5% of the patients. Serum sodium levels were not significantly
associated with alcohol consumption. Among all examination findings, icterus (p<0.05) and clubbing (p<0.01)
were found to be significantly more common among patients from group A, as compared to patients from group
B or C. Pallor, pedal edema, signs of liver cell failure and organomegaly were not significantly associated with
serum sodium levels in our study population. Portal hypertension was observed in 85.5%, hepatic
encephalopathy in 23.5%, hepatorenal syndrome in 21.5%, spontaneous bacterial peritonitis in 4.5% and
coagulopathy in 18%. Of these, hepatic encephalopathy (p<0.01), hepatorenal syndrome (p<0.01) and
coagulopathy (p<0.01) were found to occur significantly more common among patients from group A, as
compared to those in patients from group B or C. We observed that mean direct bilirubin, alanine transaminase,
aspartate transaminase and alkaline phosphatase were significantly higher among group A patients as compared
to those from group B or C respectively. We observed that mean MELD score was significantly higher among
group A patients as compared to those with group B and group C. We also observed that mean Child Pugh score
was significantly higher among group A patients as compared to those with group B and group C.
Conclusion: Patients with lower serum salt levels had a substantially higher MELD score and CPS. Low blood
sodium levels were linked to more severe liver disease, greater complications, and increased death. As a result,
we urge that serum salt levels be checked on a frequent basis in patients with chronic liver disease.