Korean J Gastroenterol.  2018 Aug;72(2):74-78. 10.4166/kjg.2018.72.2.74.

Hyponatremia in Liver Cirrhosis

Affiliations
  • 1Department of Internal Medicine, Korea Universty College of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea. 93cool@hanmail.net

Abstract

Hyponatremia is a commonly observed complication that is related to hypoalbuminemia and portal hypertension in patients with advanced liver cirrhosis. Hyponatremia in patients with liver cirrhosis is mostly dilutional hyponatremia and is defined when the serum sodium concentration is below 130 meq/L. The risk of complications increases significantly in cirrhotic patients with hyponatremia, which includes spontaneous bacterial peritonitis, hepatorenal syndrome, and hepatic encephalopathy. In addition, hyponatremia is associated with increased morbidity and mortality in patients with cirrhosis, and is an important prognostic factor before and after liver transplantation. The conventional therapies of hyponatremia are albumin infusion, fluid restriction and loop diuretics, but these are frequently ineffective. This review investigates the pathophysiology and various therapeutic modalities, including selective vasopressin receptor antagonists, for the management of hyponatremia in patients with liver cirrhosis.

Keyword

Hyponatremia; Liver cirrhosis; Hypertension portal; Antidiuretic hormone receptor antagonists

MeSH Terms

Antidiuretic Hormone Receptor Antagonists
Fibrosis
Hepatic Encephalopathy
Hepatorenal Syndrome
Humans
Hypertension, Portal
Hypoalbuminemia
Hyponatremia*
Liver Cirrhosis*
Liver Transplantation
Liver*
Mortality
Peritonitis
Sodium
Sodium Potassium Chloride Symporter Inhibitors
Antidiuretic Hormone Receptor Antagonists
Sodium
Sodium Potassium Chloride Symporter Inhibitors

Reference

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