Abstract:
Background
Chronic liver diseases cause significant morbidity and mortality worldwide. Hyponatremia is a common electrolyte finding in patients with cirrhosis, and most studies done show how hyponatremia is associated with variable complications of cirrhosis and showed its use as a prognosticator.
Objective
The study aim is to assess the prevalence of hyponatremia in decompensated cirrhosis and to identify associated factors with its occurrence
Method
A Hospital based cross-sectional study was conducted from March 2024 to January 2025 G.C at University of Gondar Comprehensive Specialized Referral Hospital. The data were collected through structured and pretested questionnaires by interviewing patients and chart review. The data were imported into STATA version 17.0 directly for analysis. Bivariable and multivariable binary logistic regression were carried out to determinant factors associated with hyponatremia. Adjusted odds ratio (AOR) with 95% confidence interval and variables with a p-value< 0.05 were considered significantly associated with hyponatremia.
Result
A total of 280 patients admitted with decompensated CLD were enrolled in this study. Hyponatremia was seen in 189 (67.5%, 95% CI: 61.6-72.9) patients. After analyzing multivariable logistic regression, Age > 45 (AOR=3.37, 95% CI: 1.56-7.31), Two or more recurrent UGIB (AOR=8.12, 95% CI: 2.42-27.26), Generalized edema (AOR=3.48, 95%CI: 1.39-8.69), Combination of furosemide and spirolactone use (AOR=3.11, 95%CI: 1.19-8.14), Serum albumin <3g/dl (AOR=3.79, 95%CI: 1.3-11.0), Serum creatinine >1.2 mg/dl (AOR=2.97, 95%CI: 1.18.02), Child-Pugh Score C (AOR=24.05, 95%CI: 7.53-76.9), Taking lactulose (AOR= 4.29, 95%CI: 1.18-15.57) were significantly associated with hyponatremia.
Conclusion and Recommendation
Hyponatremia has high prevalence among adults hospitalized with decompensated CLD. Significant independent predictors’ include age >45, ≥2 UGIB, generalized body swelling, < 3g/dl serum albumin, creatinine >1.2mg/dl, combination use of furosemide with spirolactone, taking lactulose and CPS. To improve patient outcomes, special attention should be given to high-risk individuals, frequent monitoring of electrolytes and organ function tests, aligning with guideline managements; alongside enhanced health education and further research using broader study designs and larger populations
