Portal Hemodynamics In Hyponatremic Egyptian Cirrhotic Patients

Awwaad, Shimaa A; Elbadrawy, Elsaid G; Hussien, Hala IM; Mohammed, Ahmed S; Samy, Walaa M; Zeid, Ayman F

doi:10.21608/aeji.2019.16823.1034

Portal Hemodynamics In Hyponatremic Egyptian Cirrhotic Patients

Document Type : Original Article

Authors

¹ Tropical Medicine Department,Faculty of Medicine , Zagazig University,Egypt.

² Medical Biochemistry Department,Faculty of Medicine , Zagazig University,Egypt.

³ Radiology Department,Faculty of Medicine , Zagazig University,Egypt.

10.21608/aeji.2019.16823.1034

Abstract

Background and study aim: In cirrhotic patients, portal hemodynamics is associated with hyponatremia. So, we aimed to assess portal hemodynamic changes in hyponatremic Egyptian cirrhotic patients.
Patients and Methods: one hundred and sixty cirrhotic patients due to viral causes with or without bilharziasis were included in the study, 125 males and 35 females with mean age of 50.7 years. Patients were divided into 2 groups, Group I 80 hyponatremic patients with serum Na<130mmol/L and group ΙΙ 80 Non -hyponatremic patients with serum Na>130mmol/L. All patients were exposed to full history taking, clinical examination, laboratory investigations, abdominal ultrasonography (US) with Doppler study of portal circulation and upper GIT endoscopy and followed during their stay in hospital.
Results: Serum sodium had a statistically significant positive correlation with mean portal vein (PV) velocity (r = 0.252, p= 0.001) and a highly statistically significant negative correlation with Mean flow volume, portal vein congestive index (PVCI) and hepatic artery resistive index(Hepatic A RI) (r = -0.593, r = -0.477 and, r = -0.490 respectively with p< 0.001 for all). Analysis of the receiver operating characteristic (ROC) curve revealed that portal vein congestive index was the most sensitive indicator and hepatic artery resistive index was the most specific indicator for prediction of mortality in hyponatremia patients. MELD-Na score was the most sensitive indicator and portal vein congestive index was the most specific indicator for hepatic encephalopathy prediction in hyponatremia patients.
Conclusion: Hyponatremic patients had statistically significant portal hemodynamic changes with increased morbidity and mortality in them.

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