Hyponatremia and Its Correlation With Hepatic Encephalopathy and Severity of Liver Disease: A Cross-Sectional Study

Abstract

Background: Hyponatremia is a frequently observed complication in patients with chronic liver disease (CLD), particularly in those with cirrhosis and portal hypertension. Hyponatremia aggravates hepatic encephalopathy (HE), influences prognosis, and impacts quality of life. This study aimed to determine the prevalence of hyponatremia in CLD patients and assess its correlation with the severity of HE and liver dysfunction.

Methods: The aim of the present study is to evaluate the prevalence of hyponatremia in patients with chronic liver disease and to assess its correlation with the severity of hepatic encephalopathy and liver dysfunction. This was a cross-sectional observational study conducted in the Institute of Internal Medicine of Rajiv Gandhi Government General Hospital, Chennai involving 60 patients with chronic liver disease. The study was carried out over a period of 3 months. Serum sodium levels were measured and classified as mild (130–134 mEq/L), moderate (125–129 mEq/L), or severe (<125 mEq/L) hyponatremia. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software, version 26.0 (IBM Corp., Armonk, New York, USA). Pearson’s correlation was applied to assess the relationship between continuous variables (such as ag. Chi-square tests were used to evaluate categorical outcomes . A p-value of less than 0.05 was considered statistically significant

Results: Among 60 patients, 38 (63.3%) had hyponatremia. The prevalence of hepatic encephalopathy increased significantly with worsening hyponatremia (p < 0.001). Serum sodium negatively correlated with hepatic encephalopathy grade (r = –0.61). Patients with sodium <130 mEq/L had a mean Child-Pugh score of 11.2 (Class C) and mean Model for End-Stage Liver Disease (MELD) of 27.6. A strong association was reported between Child-Pugh and MELD scores with worsening hyponatremia (p < 0.01).

Conclusion: Patients with hyponatremia are more likely to develop conditions such as hepatic encephalopathy and other electroencephalographic abnormalities. Serum sodium level is recognized as a simple, cost-effective prognostic marker for the early identification of chronic liver disease and for the grading of hepatic encephalopathy for risk stratification.Routine monitoring and early correction may improve outcomes and reduce hospitalization. An improvement in patient management and outcomes in chronic liver disease can be made by including serum sodium levels in routine clinical examination.