Re: Serum sodium and hydration status predict transplant-free survival independent of MELD score in patients with cirrhosis

[Guest guest]

I have a question about this article. IS it if your sodium is high

or low that predict transplant-free survival. A few of the times

I've had my labs drawn lately my serum sodium has been low, I really

didn't think much about it, but now I'm curious.

Thanks,

Sands

U/C 2002, PSC 11/07

>

>

http://www.ingentaconnect.com/content/bsc/jgh/2008/00000023/00000002/a

rt00015;jsessionid=11mdf6vmsphcm.alexandra

>

> Serum sodium and hydration status predict transplant-free survival

independent of MELD score in patients with cirrhosis

> Authors: Mathur, Sachin1; Gane, J; McCall, L2; Plank,

D1

>

> Source: Journal of Gastroenterology and Hepatology, Volume 23,

Number 2, February 2008 , pp. 239-243(5)

>

> Publisher: Blackwell Publishing

>

> Abstract:

>

> Background and Aim:

>

> Serum sodium may have prognostic value in addition to the model for

end-stage liver disease (MELD) score for prediction of early

mortality in patients listed for liver transplant. In patients with

cirrhosis, over-hydration is a common feature but its prognostic

value has not been evaluated. This study examines the independent

prognostic significance of MELD, serum sodium and hydration status on

long-term survival in patients with cirrhosis. Methods:

>

> Serum sodium and hydration (total body water as a percentage of fat-

free mass) were measured in 227 consecutive cirrhotic patients (146

male, 81 female; median age 49?years, range 19-73?years; median MELD

score 13, range 6-36). Patients with hepatocellular carcinoma or

listed for liver transplantation at the time of initial assessment

were excluded. A competing risks proportional hazards analysis

was performed to evaluate the influence of MELD, sodium and hydration

on risk of death or transplant. Results:

>

> Median follow-up was 52 (range 4-93) months. Serum sodium and

hydration were each associated with reduction in time to death or

transplant on univariate analysis (sodium: hazard ratio

---

0.90,

95% confidence interval [CI] 0.87-0.94, P?

> In non-waitlisted patients with cirrhosis, serum sodium is

predictive of transplant or death independent of MELD score.

> Keywords: cirrhosis; end-stage liver disease; liver

transplantation; total body water

>

> Document Type: Research article

>

> DOI: 10.1111/j.1440-1746.2007.04891.x

>

> Affiliations: 1: Department of Surgery, University of Auckland, and

the 2: New Zealand Liver Transplant Unit, Auckland City Hospital,

Auckland, New Zealand

>

[Guest guest]

The term over-hydration is used when someone is overhydrated they

have an excess of fluids in the body which causes low sodium

(hyponatremia)

Hyponatremia can be caused by acute kidney failure, diabetic

ketoacidosis, diuretics, thyroid problems, drinking to much liquid,

congestive heart failure, hyperlipids, sweating, not taking in enough

salt and many other issues.

Hyponatremia is a concern with all post opertive pts, because of the

amount of fluid pts lose due to evaperation when the body is openned

up for surgery, plus pts recieve a large amount of fluids whenever

they are on a bypass machine.

PSC 5/07 Listed

> >

> >

>

http://www.ingentaconnect.com/content/bsc/jgh/2008/00000023/00000002/a

> rt00015;jsessionid=11mdf6vmsphcm.alexandra

> >

> > Serum sodium and hydration status predict transplant-free

survival

> independent of MELD score in patients with cirrhosis

> > Authors: Mathur, Sachin1; Gane, J; McCall, L2; Plank,

> D1

> >

> > Source: Journal of Gastroenterology and Hepatology, Volume 23,

> Number 2, February 2008 , pp. 239-243(5)

> >

> > Publisher: Blackwell Publishing

> >

> > Abstract:

> >

> > Background and Aim:

> >

> > Serum sodium may have prognostic value in addition to the model

for

> end-stage liver disease (MELD) score for prediction of early

> mortality in patients listed for liver transplant. In patients with

> cirrhosis, over-hydration is a common feature but its prognostic

> value has not been evaluated. This study examines the independent

> prognostic significance of MELD, serum sodium and hydration status

on

> long-term survival in patients with cirrhosis. Methods:

> >

> > Serum sodium and hydration (total body water as a percentage of

fat-

> free mass) were measured in 227 consecutive cirrhotic patients (146

> male, 81 female; median age 49?years, range 19-73?years; median

MELD

> score 13, range 6-36). Patients with hepatocellular carcinoma or

> listed for liver transplantation at the time of initial assessment

> were excluded. A competing risks proportional hazards analysis

> was performed to evaluate the influence of MELD, sodium and

hydration

> on risk of death or transplant. Results:

> >

> > Median follow-up was 52 (range 4-93) months. Serum sodium and

> hydration were each associated with reduction in time to death or

> transplant on univariate analysis (sodium: hazard ratio

---

0.90,

> 95% confidence interval [CI] 0.87-0.94, P?

1.20, 95% CI 1.10-1.30, P?

serum sodium and hydration were independently predictive of death

or

> transplant (MELD: HR 1.12, 95% CI 1.06-1.19, P?

0.93, 95% CI 0.87-0.99, P?=?0.04; hydration: HR 1.17, 95% CI 1.02-

> 1.33, P?=?0.02). Conclusions:

> >

> > In non-waitlisted patients with cirrhosis, serum sodium is

> predictive of transplant or death independent of MELD score.

> > Keywords: cirrhosis; end-stage liver disease; liver

> transplantation; total body water

> >

> > Document Type: Research article

> >

> > DOI: 10.1111/j.1440-1746.2007.04891.x

> >

> > Affiliations: 1: Department of Surgery, University of Auckland,

and

> the 2: New Zealand Liver Transplant Unit, Auckland City Hospital,

> Auckland, New Zealand

> >

>