Clinical study on the relationship between liver cirrhosis, ascites, and hyponatremia

Xuan-Ji Li; Hui-Hui Meng

doi:10.4240/wjgs.v16.i3.751

Clinical study on the relationship between liver cirrhosis, ascites, and hyponatremia

World J Gastrointest Surg. 2024 Mar 27;16(3):751-758. doi: 10.4240/wjgs.v16.i3.751.

Authors

Xuan-Ji Li¹, Hui-Hui Meng²

Affiliations

¹ Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China.
² Department of Hepatology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430065, Hubei Province, China. lixuanji814@163.com.

Abstract

Background: Cirrhosis is a common liver disease, and ascites is one of the common clinical conditions. However, the clinical manifestations of ascites combined with hyponatremia as a high-risk condition and its relationship to patient prognosis have not been fully studied.

Aim: To explore the clinical manifestations, prognostic factors, and relationships of ascites with hyponatremia in patients with cirrhosis to provide better diagnostic and treatment strategies.

Methods: In this study, we retrospectively analyzed the clinical data of 150 patients diagnosed with cirrhosis and ascites between 2017 and 2022. Patients were divided into two groups: ascites combined with hyponatremia group and ascites group. We compared the general characteristics, degree of hyponatremia, complications, treatment, and prognosis between the two groups.

Results: In the study results, patients in the ascites combined with hyponatremia group showed an older average age (58.2 ± 8.9 years), 64.4% were male, and had a significantly longer hospitalization time (12.7 ± 5.3 d). Hyponatremia was more severe in this group, with a mean serum sodium concentration of 128.5 ± 4.3 mmol/L, which was significantly different from the ascites group of 137.6 ± 2.1 mmol/L. Patients with ascites and hyponatremia were more likely to develop hepatic encephalopathy (56.2% vs 39.0%), renal impairment (45.2% vs 28.6%) and infection (37.0% vs 23.4%). Regarding treatment, this group more frequently used diuretics (80.8% vs 62.3%) and salt supplements (60.3% vs 38.9%). Multiple logistic regression analysis identified older age [Odds ratio (OR) = 1.06, P = 0.025] and male gender (OR = 1.72, P = 0.020) as risk factors for hyponatremia combined with ascites. Overall, patients with ascites and hyponatremia present a clear high-risk status, accompanied by severe complications and poor prognosis.

Conclusion: In patients with cirrhosis, ascites with hyponatremia is a high-risk condition that is often associated with severe complications.

Keywords: Ascites; Complications; Hyponatremia; Liver cirrhosis; Risk.