Sunday, April 16, 2017

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.


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.

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