Volume 6 Issue 6 (November - December), 2020

Original Articles

Study and prognostication of hyponatremia in hepatic encephalopathy of chronic liver disease
Shubham Malani, Prasanna Kumar Satpathy, Shubham Agrawal, Sreekar Sura, Bharath Gowda

Background: Chronic liver disease (CLD) is a pathologic entity characterized by continuous advancing worsening of hepatic functions for a minimum of six to seven months. Hepatic encephalopathy (HE) is a rescindable group of pathologies manifesting in the form of impairment in brain function, occurring in subjects with progressive hepatic failure. Hyponatremia is one of the commonest electrolyte dysfunction problem found to be significantly prevalent among hospitalized subjects. Hence; the present study was undertaken for assessing the prognostication of hyponatremia in hepatic encephalopathy of chronic liver disease. Materials & methods: 50 consecutive patients with Hepatic Encephalopathy due to Chronic Liver Disease were enrolled. A detailed clinical history was taken of all the patients and/or relatives regarding the etiology of the disease which included the patients suffering from existing liver disease for more than 10 years and known cases of Chronic Liver Disease for more than 6 months with abnormal LFT were selected. Sodium levels were assessed and incidence of hyponatremia was evaluated. SPSS software was used for evaluation of level of significance. Results: Hyponatremia was found to be present in 30 percent of the patients (3 patients) with grade I Hepatic encephalopathy, 27.27 percent of the patients (3 patients) with grade II Hepatic encephalopathy, 69.23 percent of the patients (9 patients) with grade III Hepatic encephalopathy and 81.25 percent of the patients (14 patients) with grade IV Hepatic encephalopathy. Significant results were obtained while assessing the occurrence of hyponatremia in difference grades of hepatic encephalopathy. While analyzing the correlation between sodium levels and severity of hepatic encephalopathy, significant results were obtained. Mean sodium levels among patients with Grade I HE, grade II HE, Grade III HE and Grade IV HE was found to be 139.41 mEq/L, 140.14 mEq/L, 133.40 mEq/L and 131.0 mEq/L respectively. 20 percent of the patients with Child Pugh Score A, 23.8 percent of the patients with Child Pugh score B and 91.97 percent of the patients with Child Pugh score C had hyponatremia. While analyzing the correlation between sodium levels and severity of hepatic encephalopathy, significant results were obtained. Conclusion: Hyponatremia is a common feature in patients with hepatic encephalopathy and its severity increased with its increasing grade of severity of disease. Close monitoring of serum sodium concentration should be performed in patients with cirrhosis in order to prevent the rapid development of cirrhosis related complications. Key words: Hyponatremia, hepatic encephalopathy, Hyponatremia

 
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