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Relationship and interaction between serum sodium concentration and portal hemodynamics in patients with cirrhosis
Author(s) -
Maruyama Hitoshi,
Kondo Takayuki,
Kiyono Soichiro,
Sekimoto Tadashi,
Takahashi Masanori,
Okugawa Hidehiro,
Yokosuka Osamu
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13006
Subject(s) - hyponatremia , medicine , cirrhosis , gastroenterology , hemodynamics , ascites , hazard ratio , prothrombin time , confidence interval
Background and Aim To examine the relationship between hyponatremia and portal hemodynamics and their effect on the prognosis of cirrhosis. Methods Portal hemodynamic parameters measured by D oppler ultrasound and serum sodium concentrations were examined in 153 cirrhosis patients (mean age 62.2 ± 12.0 years; median observation period, 34.1 m). Results Study participants included 16 patients with hyponatremia ( Na < 135 mEq/L), who showed a significantly greater frequency of possessing a splenorenal shunt ( SRS ; P = 0.0068), and 137 patients without hyponatremia. Serum sodium concentrations were significantly lower in patients with SRS than in those without ( P = 0.0193). An increased prothrombin time‐international normalized ratio was a significant predictive factor for developing hyponatremia a year later (8/96; Hazard ratio 14.415; P = 0.028). The cumulative survival rate was significantly lower in patients with hyponatremia (46.7% at 1 and 3 years) than in those without (91.8% at 1 year, 76.8% at 3 years; P < 0.001). The cumulative survival rate was significantly lower in patients who had developed hyponatremia after 1 year (100% at 1 year, 62.5% at 3 years) than those who had not (100% at 1 year, 89.0% at 3 years; P < 0.001). The cumulative survival rate was significantly worse in patients with both hyponatremia and SRS (20% at 1 year). Conclusions There was a close linkage between the serum sodium concentration and portal hemodynamic abnormality, presence of SRS , and their interaction may negatively influence the prognoses in cirrhosis.