Association of hyponatremia with degree of liver injury and complications in patients with decompensated liver cirrhosis

ObjectiveTo investigate the association of hyponatremia with the degree of liver injury and complications in patients with decompensated liver cirrhosis. MethodsA retrospective analysis was performed for the clinical data of 142 patients with decompensated liver cirrhosis complicated by hyponatremia who were admitted to Department of Gastroenterology, Xijing Hospital of Fourth Military Medical University from July 2015 to July 2016. The patients were divided into mild group, moderate group, and severe group according to serum sodium concentration on admission. The Child-Pugh score, Model for End-Stage Liver Disease (MELD) score, and major complications were compared between groups. All the patients were followed up for 3 months, and the complications such as ascites, spontaneous bacterial peritonitis, and hepatic encephalopathy were recorded. The association of hyponatremia with complications and mortality was investigated. The chi-square test was used for comparison of categorical data between groups, and the Spearman corretation analysis was also performed. ResultsThe mild group had a high proportion of Child-Pugh class A patients (42.3%) and the severe group had a high proportion of Child-Pugh class C patients (72.4%). There was a significant difference in Child-Pugh score between the mild, moderate, and severe groups (χ2=50.175, P=0.000 2). The serum sodium level decreased with the increasing Child-Pugh score (r=-0.464, P=0.002 3). The mild group had a high proportion of patients with an MELD score of ≤9 (50.7%) and the severe group had a high proportion of patients with an MELD score of ≥30 (62.1%). There was a significant difference in the distribution of MELD scores between the mild, moderate, and severe groups (χ2=75.106, P=0.000 8). The serum sodium level decreased with the increasing MELD score (r=-0.644, P=0.004 5). The incidence rates of ascites, spontaneous bacterial peritonitis, and hepatic encephalopathy were 71.8%/92.9%/100.0%, 14.1%/31.0%/65.5%, and 14.1%/35.7%/55.2%, respectively, in the mild, moderate, and severe groups. The mortality rate was 12.7%, 33.3%, and 65.5% in these three groups, respectively. There were significant differences in the incidence rate of complications and mortality rate between the three groups (χ2=14.127 and 24.467, both P＜0.05). ConclusionSerum sodium level can be used as a predictor for the incidence rate of complications in patients with decompensated liver cirrhosis.