Aim: To study the prevalence of hyponatremia in patients with chronic liver disease attending the outpatient department of a tertiary care hospital. Methodology: An observational cross-sectional study was conducted in the department of medicine, Darbhanga Medical College and Hospital, Darbhanga, Bihar for one year .In this study, patients in the age group of 18 to 65 years were included irrespective of gender, diagnosed with chronic liver disease. A history, physical examination, biochemical markers, ultrasonography, and upper gastrointestinal endoscopy were used to identify cirrhosis. Child-Turcotte Pugh score (CPS) and model for end stage liver disease (MELD) score was calculated for all patients [16]. Those with serum sodium levels less than or equal to 130 meq/l were classified as group A, those with serum sodium levels between 131-135 meq/l as group B and those with serum sodium levels greater than or equal to 136 meq/l as group C. Descriptive analysis of quantitative parameters was expressed as means and standard deviation. Results: In the present study, 100 patients were included. It was observed that 32% were in group A (≤ 130 mEq/l), 34% were in group B (131 to 135 mEq/l) and 34% were in group C (≥ 136 mEq/l). The age or gender of the patients was not associated with serum sodium levels. It was observed that patients from group A had jaundice (p<0.05) and altered sensorium (p<0.05) significantly more commonly as compared to those from group B and C. Serum sodium levels was not significantly associated with alcohol consumption. Among all examination findings, icterus (p<0.05) and clubbing (p<0.05) were found to be significantly more common among patients from group A, as compared to patients from group B or C. Pallor, pedal edema, signs of liver cell failure and organomegaly were not significantly associated with serum sodium levels in our study population. Hepatic encephalopathy (p<0.01), hepatorenal syndrome (p<0.01) and coagulopathy (p<0.01) were found to occur significantly more common among patients from group A, as compared to those in patients from group B or C. We also observed that mean direct bilirubin, alanine transaminase, aspartate transaminase and alkaline phosphatase were significantly higher among group A patients as compared to those from group B or C respectively. In addition, we observed that mean MELD (The Model for End-stage Liver Disease) score was significantly higher among group A patients (18.04+7.52) as compared to those with group B (13.24+5.02) and group C (12.04+4.72). We also observed that mean Child Pugh score (CPS) was significantly higher among group A patients (10.04+2.82) as compared to those with group B (8.72+1.45) and group C (7.34+2.02). Overall, 12% of the patients expired. Conclusion: Decompensated Chronic Liver Disease is associated with abnormal serum sodium concentration. Individuals with lower serum salt levels had a substantially higher MELD score and CPS. Furthermore, hepatic encephalopathy, hepatorenal syndrome, and coagulopathy were shown to be considerably more prevalent in individuals with blood sodium levels more than 136 mEq/l than in other patients.

Aim: To study the prevalence of hyponatremia in patients with chronic liver disease attending the outpatient department of a tertiary care hospital. Methodology: An observational cross-sectional study was conducted in the department of medicine, Darbhanga Medical College and Hospital, Darbhanga, Bihar for one year .In this study, patients in the age group of 18 to 65 years were included irrespective of gender, diagnosed with chronic liver disease. A history, physical examination, biochemical markers, ultrasonography, and upper gastrointestinal endoscopy were used to identify cirrhosis. Child-Turcotte Pugh score (CPS) and model for end stage liver disease (MELD) score was calculated for all patients [16]. Those with serum sodium levels less than or equal to 130 meq/l were classified as group A, those with serum sodium levels between 131-135 meq/l as group B and those with serum sodium levels greater than or equal to 136 meq/l as group C. Descriptive analysis of quantitative parameters was expressed as means and standard deviation. Results: In the present study, 100 patients were included. It was observed that 32% were in group A (≤ 130 mEq/l), 34% were in group B (131 to 135 mEq/l) and 34% were in group C (≥ 136 mEq/l). The age or gender of the patients was not associated with serum sodium levels. It was observed that patients from group A had jaundice (p<0.05) and altered sensorium (p<0.05) significantly more commonly as compared to those from group B and C. Serum sodium levels was not significantly associated with alcohol consumption. Among all examination findings, icterus (p<0.05) and clubbing (p<0.05) were found to be significantly more common among patients from group A, as compared to patients from group B or C. Pallor, pedal edema, signs of liver cell failure and organomegaly were not significantly associated with serum sodium levels in our study population. Hepatic encephalopathy (p<0.01), hepatorenal syndrome (p<0.01) and coagulopathy (p<0.01) were found to occur significantly more common among patients from group A, as compared to those in patients from group B or C. We also observed that mean direct bilirubin, alanine transaminase, aspartate transaminase and alkaline phosphatase were significantly higher among group A patients as compared to those from group B or C respectively. In addition, we observed that mean MELD (The Model for End-stage Liver Disease) score was significantly higher among group A patients (18.04+7.52) as compared to those with group B (13.24+5.02) and group C (12.04+4.72). We also observed that mean Child Pugh score (CPS) was significantly higher among group A patients (10.04+2.82) as compared to those with group B (8.72+1.45) and group C (7.34+2.02). Overall, 12% of the patients expired. Conclusion: Decompensated Chronic Liver Disease is associated with abnormal serum sodium concentration. Individuals with lower serum salt levels had a substantially higher MELD score and CPS. Furthermore, hepatic encephalopathy, hepatorenal syndrome, and coagulopathy were shown to be considerably more prevalent in individuals with blood sodium levels more than 136 mEq/l than in other patients.