Azam Muhammad Usman, Saeed Najam-Us-Sehar, Javed Salman, Memon Muuhammad Yousuf Y, Aftab Muhammad Asad, Shafqat Muhammad Nabeel, Sadiq Hafiz Zeeshan, Maqbool Arman, Mand Khan Fasih, Zahoor Faizan
Department of Medicine, Gujranwala Medical College/Teaching Hospital, Gujranwala, PAK.
Department of Gastroenterology and Hepatology, Gujranwala Medical College/Teaching Hospital, Gujranwala, PAK.
Cureus. 2024 Sep 7;16(9):e68907. doi: 10.7759/cureus.68907. eCollection 2024 Sep.
Liver cirrhosis is a prominent global contributor to mortality, and hyponatremia is a common complication in patients with decompensated chronic liver disease (DCLD). Hyponatremia is characterized by kidney impairment when eliminating solute-free water. The presence of contradictory findings in existing literature prompted this study.
The objective of this study was to determine the prevalence of hyponatremia in patients with DCLDs presenting at a tertiary care hospital.
This six-month cross-sectional study was performed at the Allied Institute of Medical Sciences Teaching Hospital in Gujranwala, Pakistan, from January 2022 to June 2022. A total of 133 patients were selected as subjects. Researchers took blood samples from these patients and sent the samples to the hospital pathology lab for evaluation of serum sodium levels. If sodium levels were ≤130 mmol/L, the patient was considered to have hyponatremia. All information was recorded on proforma.
The mean age of patients was 47.68 ± 12.89 years. Overall, 80 (60.15%) were male, and 53 (39.85%) female. The mean BMI of patients was 23.20 ± 3.11 kg/m and the average duration of DCLD was 7.24 ± 4.12 years. Among participants, 48 (36.09%) patients had hyponatremia, whereas 85 (63.91%) did not have hyponatremia. The mean sodium level was 132.39 ± 11.37 mEq/L. Stratified analysis based on patient age revealed that among patients aged 21-45 years, 27 (45.8%) had hyponatremia, whereas, in the group aged 46-70 years, 21 (28.4%) had hyponatremia with a p-value < 0.05. Stratification of the basis of BMI, among underweight patients, all eight (100%) had hyponatremia, whereas of overweight patients, 14 (31.1%) had hyponatremia. This difference was statistically significant (p < 0.05).
The prevalence of hyponatremia was notably elevated among individuals suffering from DCLD. Age and BMI were the most common risk factors for hyponatremia among subjects with DCLD. This study recommends that patients with DCLD should have their serum sodium levels screened at regular intervals to prevent complications, including encephalopathy, which occurs particularly in younger and underweight DCLD patients.
肝硬化是全球死亡率的一个重要因素，低钠血症是失代偿期慢性肝病（DCLD）患者的常见并发症。低钠血症的特征是在排出无溶质水时肾脏功能受损。现有文献中相互矛盾的研究结果促使了本研究的开展。
本研究的目的是确定在一家三级护理医院就诊的DCLD患者中低钠血症的患病率。
这项为期六个月的横断面研究于2022年1月至2022年6月在巴基斯坦古杰兰瓦拉的联合医学科学教学医院进行。总共选择了133名患者作为研究对象。研究人员采集了这些患者的血样，并将样本送往医院病理实验室评估血清钠水平。如果钠水平≤130 mmol/L，则该患者被认为患有低钠血症。所有信息都记录在表格上。
患者的平均年龄为47.68±12.89岁。总体而言，80名（60.15%）为男性，53名（39.85%）为女性。患者的平均体重指数为23.20±3.11 kg/m，DCLD的平均病程为7.24±4.12年。在参与者中，48名（36.09%）患者患有低钠血症，而85名（63.91%）没有低钠血症。平均钠水平为132.39±11.37 mEq/L。根据患者年龄进行的分层分析显示，在21 - 45岁的患者中，27名（45.8%）患有低钠血症，而在46 - 70岁的组中，21名（28.4%）患有低钠血症，p值<0.05。根据体重指数分层，在体重过轻的患者中，所有8名（100%）都患有低钠血症，而在超重患者中，14名（31.1%）患有低钠血症。这种差异具有统计学意义（p<0.05）。
DCLD患者中低钠血症的患病率显著升高。年龄和体重指数是DCLD患者中低钠血症最常见的危险因素。本研究建议，DCLD患者应定期筛查血清钠水平，以预防并发症，包括特别是在年轻和体重过轻的DCLD患者中发生的脑病。
