Q; Looking trend of which electrolyte may provide good survival and prognastic value in cirrhosis patients?


Answer: Sodium

 Hyponatremia is slow but progressive in patients with cirrhosis, and correlates with severity of disease and mortality. It is due to water retention and that's why usually read/graded and correlates with the severity of Ascites. Hyponatremia has been found to be a very powerful predictor of death in patients with cirrhosis and ascites who are on the liver transplant waiting list. Sodium is now officially incorporated in MELD score.


References:

1. Angeli P, Wong F, Watson H, et al. Hyponatremia in cirrhosis: Results of a patient population survey. Hepatology 2006; 44:1535. 

2. Heuman DM, Abou-Assi SG, Habib A, et al. Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death. Hepatology 2004; 40:802. 

3. Biggins SW, Rodriguez HJ, Bacchetti P, et al. Serum sodium predicts mortality in patients listed for liver transplantation. Hepatology 2005; 41:32. 

4.Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med 2008; 359:1018.