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Relationship between urinary fractional excretion of sodium and life prognosis in liver cirrhosis patients
Author(s) -
Ohashi Naro,
Tsuji Naoko,
Naito Yoshitaka,
Iwakura Takamasa,
Isobe Shinsuke,
Ono Masafumi,
Fujikura Tomoyuki,
Tsuji Takayuki,
Sakao Yukitoshi,
Yasuda Hideo,
Kawamura Kinya,
Sakaguchi Takanori,
Kato Akihiko,
Fujigaki Yoshihide
Publication year - 2013
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12068
Subject(s) - medicine , fractional excretion of sodium , cirrhosis , alcoholic hepatitis , gastroenterology , renal function , liver disease , hepatitis , prothrombin time , uremia , endocrinology , alcoholic liver disease
Aim Renal vasoconstriction in generalized vasodilatation with blood pooling and the consequent reduction in effective arterial volume is the pathophysiological basis of liver cirrhosis ( LC ). Low levels of fractional excretion of sodium ( FENa ) are an effective marker of hypoperfusion of the renal artery. However, the relationship between levels of FENa , LC severity and life prognosis has not yet been elucidated. Methods We examined 57 LC patients (39 men and 18 women; mean age, 70.5 ± 8.8 years; underlying liver disease, type B hepatitis in eight patients, type C hepatitis in 37, alcoholic hepatitis in four and others in eight) with renal dysfunction (estimated glomerular filtration rate ( eGFR ) <60 mL /min) who were admitted to our hospital. Results Nine patients died because of uremia, liver failure, gastrointestinal bleeding and infection. No differences were found in patient background and blood pressure. However, in addition to differences in the levels of aspartate aminotransferase ( AST ), cholinesterase, albumin, prothrombin time ( PT ), e GFR and M odel for E nd‐ S tage L iver D isease ( MELD ) score, the patients who died had significant differences in levels of FENa . The levels of FENa were significantly and inversely correlated with blood urea nitrogen, total bilirubin, AST , C hild– P ugh score and MELD score, and were significantly and positively correlated with cholinesterase, albumin and PT . Moreover, the sensitivity (88%) and specificity (93%) of the levels of FEN a of less than 0.4% to predict death were remarkably high. Conclusion Levels of FEN a may reflect LC severity and may be associated with the life prognosis of LC patients.