IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 20, Issue 9 Ser.2 (September. 2021), PP 06-09 www.iosrjournals.org DOI: 10.9790/0853-2009020609 www.iosrjournal.org 6 | Page A Study of Hyponatremia in Cirrhosis of Liver and Its Prognostic Value Ajeet Kumar Gadhwal 1 , *Mohd Arif 2 1 Assistant Professor, Department Of General Medicine, PDU Medical College & Associated Group of Hospitals, Churu, Rajasthan, India 2 Assistant Professor, Department Of General Medicine, PDU Medical College & Associated Group of Hospitals, Churu, Rajasthan, India *Corresponding author’s Email-drarifkhan17@gmail.com Abstract Background/Aims: Dilutional hyponatremia associated with liver cirrhosis is caused by impaired free water clearance. Several studies have shown that serum sodium levels correlate with survival in cirrhotic patients. Little is known regarding the relationship between the degree of dilutional hyponatremia and development of cirrhotic complications. The aim of this study was to study the prevalence of hyponatremia in cirrhosis and evaluate the association between the serum sodium level and the severity of complications in liver cirrhosis and its prognostic significance. Methods: It was conducted in the Department of General Medicine, PDU Medical College, Churu, Rajasthan, from Jan-2019 to Dec-2019. Data of patients with cirrhosis were collected prospectively. The prevalence and serum sodium levels and severity of complications of 100 patients were analyzed. Results: The prevalence of dilutional hyponatremia, classified as serum sodium concentrations of <135 meq/L and ≤130 meqL, were 34%, 20% respectively. The serum sodium level was strongly associated with the severity of liver function impairment as assessed by Child-Pugh and MELD scores (p<0.0001). Sodium levels less than 130 meq/L indicated the existence of grade III or higher hepatic encephalopathy (OR, 10.5; CI, 3.08-35.8; p=<0.0001), Hepato-renal syndrome 15.70(95% CI=0.86-287.8; P=<0.0113). Patients with serum sodium<130meq/L had the greatest frequency of these complications, but the frequency was also increased in patients with mild reduction in serum sodium levels (131-135 meq/L). Conclusions: Dilutional hyponatremia is frequent in cirrhotic patients and low serum sodium levels in cirrhosis are associated with severe complications of liver cirrhosis like hepatic encephalopathy, hepatorenal syndrome and high morbidity and mortality. Treatment of hyponatremia is important to prevent possible complications of liver cirrhosis. Keywords: Hyponatremia , liver cirrhosis, hepatic encephalopathy --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 20-08-2021 Date of Acceptance: 05-09-2021 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction: Hyponatremia is serum sodium less than 135 meq/L. Hyponatremia is the most common electrolyte disorder. 1 Its homeostasis is vital to the normal physiologic function of cells. A disturbance in body water homeostasis is a common feature of advanced cirrhosis. 1-7 This is characterized by a higher rate of renal retention of water in relation to sodium due to a reduction in solute-free water clearance. The consequent inability to adjust the amount of water excreted in the urine to the amount of water Ingested leads to dilutional hyponatremia. Hyponatremia, an excess of water in relation to the sodium in the extracellular fluid, is the most common electrolyte disorder in hospitalized patients and particularly in patients with cirrhosis. 6,7,8-16 . Clinically significant hyponatremia is relatively uncommon and is nonspecific in its presentation; therefore, the physician must consider the diagnosis in patients presenting with vague constitutional symptoms or with altered level of consciousness. Identifying the etiology and risk factors for hyponatremia will help in reducing its incidence and minimize the complications associated with hyponatremia and improve the overall cost of health care. Patients with hyponatraemia have a poor survival compared with that of patients without hyponatraemia. 11 Hyponatremia has been associated with refractory ascites, spontaneous bacterial peritonitis and hepatic encephalopathy in patients with cirrhosis. Hyponatremia can be a key prognostic factor in patients with cirrhosis of liver when it is added to MELD score. Thus, hyponatremia could be useful in predicting prognosis & development of complications in cirrhotic patients. 2 There is a lack of Indian data on clinical spectrum of hyponatremia in cirrhosis and treatment modalities to be