Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh School of Medicine, 3550 Terrace Street, A915 Scaife Hall, Pittsburgh, PA 15261, USA.
Department of Nephrology, Ochsner Health, 1514 Jefferson Highway, Clinic Tower 5th, Floor, Room 5E328, New Orleans, LA 70121, USA; Ochsner Clinical School/The University of Queensland, Brisbane, Queensland, Australia. Electronic address: https://twitter.com/VelezNephHepato.
Clin Liver Dis. 2022 May;26(2):149-164. doi: 10.1016/j.cld.2022.01.001. Epub 2022 Apr 1.
Hyponatremia is the most common electrolyte disorder encountered in clinical practice, and it is a common complication of cirrhosis reflecting an increase in nonosmotic secretion of arginine vasopressin as a result of of the circulatory dysfunction that is characteristic of advanced liver disease. Hyponatremia in cirrhosis has been associated with poor clinical outcomes including increased risk of morbidity and mortality, poor quality of life, and heightened health care utilization. Despite this, the treatment of hyponatremia in cirrhosis remains challenging as conventional therapies such as fluid restriction are frequently ineffective. In this review, we discuss the epidemiology, clinical outcomes, pathogenesis, etiology, evaluation, and management of hyponatremia in cirrhosis.
低钠血症是临床实践中最常见的电解质紊乱，也是肝硬化的常见并发症，反映了由于晚期肝病特有的循环功能障碍导致非渗透性精氨酸血管加压素分泌增加。肝硬化伴低钠血症与不良临床结局相关，包括发病率和死亡率增加、生活质量差和医疗保健利用率增加。尽管如此，肝硬化伴低钠血症的治疗仍然具有挑战性，因为常规治疗如液体限制通常无效。在这篇综述中，我们讨论了肝硬化伴低钠血症的流行病学、临床结局、发病机制、病因、评估和管理。
