Research On The Relationships Of Serum Sodium Levels And Serum-ascites Albumin Gradient With Hepatorenal Syndrome In Patients With Decompensated Cirrhosis

Objective: To research the relationships of serum sodium level, serum-ascitesalbumin gradient (SAAG) with hepatorenal syndromevalue (HRS), and to explore therole of serum sodium level and SAAG value on forecast of the incidence ofhepatorenal syndromevalue (HRS) in patients with decompensated cirrhosis.Methods:60hospitalized patients with decompensated cirrhosis diagnosed in theAffiliated Hospital of Qinghai University from October2011to November2012wereinvolved in this study. In each subject, the serum sample was collected in fasting stateand the blood biochemical test was performed. The ascites was collected byabdominocentesis and the albumin content was detected. And the SAAG value wascalculated. Analysis hyponatremia group and hyponatremia indicators of liverfunction tests normal group differences and SAAG value differences in liver function(CTP) class A, B, and C grade patients.60patients were divided into the HRS groupand non-HRS group were compared serum sodium and SAAG value differences;40patients with hyponatremia were divided into mild hyponatremia group, moderatehyponatremia group according to the grading standards of hyponatremia, severehyponatremia group, HRS incidence difference between comparing different groups;60cases were also divided into three groups according to the different range of SAAGvalues (11g/L<SAAG≤15g/L,15g/L<SAAG≤20g/L, SAAG>20g/L), respectively.The incidences of HRS were compared among three groups.Results:1. The hyponatremia group of serum liver function test items TB was significantlyhigher than that hyponatremia normal group, AlB below hyponatremia normal group,the difference was statistically significant (P <0.05), but enzymology indicators ALT, AST was no statistical differencesignificance.Liver function CTP class A, group B-level group and C-level group, SAAGvalues between the three groups was significantly different between the two groupswith significant difference (P <0.05).2. Hepatorenal syndrome patients with hyponatremia average lower thannon-hepatorenal syndrome group, SAAG in the average higher than the non-hepatorenal syndrome group, the difference was statistically significant (P <0.05).Normal group, mild low sodium blood sodium, sodium moderately low sodiumgroup and severe group comparison between the four groups, the incidence of HRSwas different, there were statistical differences (P>0.05); Parallel trend test (P <0.05), which indicates that with the decrease of serum sodium level, the higherincidence of HRS.Different level of SAAG(11g/L<SAAG≤15g/L,15g/L<SAAG≤20g/L,SAAG>20g/L), among the three groups HRS incidence between groups statisticallysignificanted difference (P <0.01).Conclusions:1. Sodium metabolism is a common complication of decompensated cirrhosis, thehyponatremia induced hepatorenal syndrome, serum sodium level is a more sensitiveindicator for monitoring the hepatorenal syndrome occurred.2. SAAG level is an important indicator to reflect liver dysfunction and portalhypertension,the higher the level of SAAG in higher HRS incidence. SAAG level is amore sensitive indicator for monitoring hepatorenal syndrome occurred.3. Combined detection of serum sodium levels and SAAG values conducive to theoccurrence of early diagnosis of HRS, the detection method is simple, easy to grasp,the detection of low-cost, important clinical significance.