THE PREVALENCE OF HYPONATREMIA IN DECOMPENSATED CHRONIC LIVER DISEASE AND ITS CORRELATION WITH CLINICAL SEVERITY SCORES.

Background: Hyponatremia is a frequent and significant electrolyte disturbance in patients with decompensated chronic liver disease (DCLD), reflecting the severity of liver dysfunction and systemic complications. It is primarily caused by impaired solute-free water clearance due to hyperactivation of vasopressin and reduced effective circulating volume, leading to dilutional hyponatremia. Clinically, hyponatremia is associated with worse outcomes, including increased susceptibility to infections, prolonged hospitalizations, hepatic encephalopathy, and higher mortality rates.This study aimed to assess the prevalence of hyponatremia in patients with decompensated chronic liver disease (DCLD) and its correlation with disease severity,as measured by Child-Turcotte-Pugh (CTP),Model for End-Stage Liver Disease (MELD), and MELD-sodium (MELD-Na) scores.Methodology: A prospective observational cross-sectional study was conducted involving 110 patients diagnosed with DCLD at hospitals affiliated with Bangalore Medical College and Research Institute from August 2022 to January 2024. Detailed demographic, clinical, and biochemical data were collected from patients meeting the inclusion criteria. Disease severity was assessed using the Child-Turcotte-Pugh (CTP), MELD, and MELD-Na scores. Results :Hyponatremia was observed in 62 patients (56.36%), with mean sodium concentrations of 134.0 ± 5.5 mEq/L in the overall group and 129.94 ± 2.97 mEq/L in those with hyponatremia.Patients were classified into mild (33.6%),moderate (22.72%),and severe (0%) hyponatremia categories.We also found higher Child-Pugh ,MELD and MELD-Na scores in patient with hyponatremia. Ethanol consumption was the leading etiology (90%), followed by cryptogenic cirrhosis, MAFLD, and hepatitis C infection. Conclusion: These findings highlight the high prevalence of hyponatremia in DCLD and highlight the need for routine monitoring of serum sodium levels in patients with DCLD to facilitate better management and improve clinical outcomes. Early detection and timely interventions to correct hyponatremia may not only help mitigate complications such as hepatic encephalopathy, infections,and renal dysfunction but also improve overall survival rates and quality of life for these patients