CLINICAL STUDY OF ASSOCIATION BETWEEN THE SERUM SODIUM LEVEL AND SEVERITY OF COMPLICATIONS IN LIVER CIRRHOSIS AT KANYAKUMARI GOVERNMENT MEDICAL COLLEGE.

Background: Cirrhosis is defined histopathologically and has variety of clinical manifestations and complications, some of which can be life-threatening..Dilutionalhyponatremia associated with liver cirrhosis is caused by impaired free water clearance . The aim of this study was to evaluate the association between the serum sodium level and the severity of complications in liver cirrhosis . Methods:This study was conducted in Kanyakumari Government Medical College in the department of general medicine . 200 patients were included in the study over a period from August 2017 ? August 2018 for a period of 1 year . Data of inpatients with cirrhotic complications were collected retrospectively . The serum sodium level and severity of complications of 200 inpatients were analysed. Results:The prevalence of dilutionalhyponatremia, classified as serum sodium concentrations of >135 mmol/L, 131-135 mmol/L, and ≤130 mmol/L, were 44%, 24%, and 32%, 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). Even a mild hyponatremia with a serum sodium concentration of 131-135 mmol/L was associated with severe complications. Conclusion: Hyponatremia is more common in liver cirrhosis and low serum sodium levels are associated with complications such as hepatic encephalopathy ,hepatorenal syndrome , spontaneous bacterial peritonitis and GI bleeding . Lower serum sodium levels were associated with increased MELD CPS score and mortality indicating the inverse relationship between serum sodium levels and severity of the disease.