Published online Mar 27, 2024. doi: 10.4240/wjgs.v16.i3.751
Peer-review started: December 22, 2023
First decision: January 9, 2024
Revised: January 12, 2024
Accepted: January 31, 2024
Article in press: January 31, 2024
Published online: March 27, 2024
Cirrhosis is a common liver disease, and ascites is one of the common clinical conditions. However, the clinical manifestations of ascites combined with hyponatremia as a high-risk condition and its relationship to patient prognosis have not been fully studied.
To explore the clinical manifestations, prognostic factors, and relationships of ascites with hyponatremia in patients with cirrhosis to provide better diagnostic and treatment strategies.
In this study, we retrospectively analyzed the clinical data of 150 patients diagnosed with cirrhosis and ascites between 2017 and 2022. Patients were divided into two groups: ascites combined with hyponatremia group and ascites group. We compared the general characteristics, degree of hyponatremia, complications, treatment, and prognosis between the two groups.
In the study results, patients in the ascites combined with hyponatremia group showed an older average age (58.2 ± 8.9 years), 64.4% were male, and had a significantly longer hospitalization time (12.7 ± 5.3 d). Hyponatremia was more severe in this group, with a mean serum sodium concentration of 128.5 ± 4.3 mmol/L, which was significantly different from the ascites group of 137.6 ± 2.1 mmol/L. Patients with ascites and hyponatremia were more likely to develop hepatic encephalopathy (56.2% vs 39.0%), renal impairment (45.2% vs 28.6%) and infection (37.0% vs 23.4%). Regarding treatment, this group more frequently used diuretics (80.8% vs 62.3%) and salt supplements (60.3% vs 38.9%). Multiple logistic regression analysis identified older age [Odds ratio (OR) = 1.06, P = 0.025] and male gender (OR = 1.72, P = 0.020) as risk factors for hyponatremia combined with ascites. Overall, patients with ascites and hyponatremia present a clear high-risk status, accompanied by severe complications and poor prognosis.
In patients with cirrhosis, ascites with hyponatremia is a high-risk condition that is often associated with severe complications.
Core Tip: This study found that ascites combined with hyponatremia is a high-risk condition in patients with cirrhosis, which is characterized by older patients, an increased proportion of males, and prolonged hospitalization. Hyponatremia is more pronounced in this setting, with an increase in hepatic encephalopathy, renal impairment, and infection. Diuretics and salt supplements are preferred in treatment options. The poor prognosis of patients with ascites and hyponatremia prompts more attention to this patient in clinical practice and the adoption of timely and effective treatment measures, especially risk management for elderly and male patients.