"In our study, the prevalence of hyponatremia was significantly higher in patients who died within 3 months (63 percent) than in those who survived 3 months (13 percent)," the authors note. "Similarly, patients with hyponatremia had significantly more advanced liver failure compared to those with normal serum sodium." They add that although hyponatremia ultimately reflects renal impairment, it appears to be a more accurate and early marker of poor outcome than serum creatinine in transplant candidates with advanced cirrhosis.
According to the study, serum sodium, like bilirubin, INR, and creatinine, is an objective, quantitative and reproducible laboratory test, and is therefore a good candidate for inclusion in the mathematical formula of the MELD score. While serum sodium can be decreased with the use of diuretics and can therefore be manipulated, this disadvantage also applies to serum creatinine. The authors conclude that the study "shows that hyponatremia is an excellent predictor of outcome in patients with advanced cirrhosis and significantly increases the efficacy of MELD to predict waitlist mortality."
The work outlined in this news alert was supported by the Foundation for Research and Education in Liver Diseases in Buenos Aires, Argentina.