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Abstract
This study was carried out on 40 patients presenting with liver cirrhosis and ascites, admitted at Ain Shams University Hospitals.
The aim of this study is to evaluate the accuracy of using spot urinary sodium/potassium ratio and spot urinary sodium/creatinine ratio as a reliable alternative to 24 hours urinary sodium in assessment of dietary sodium compliance in patients with liver cirrhosis receiving diuretics.
The studied patients were divided into 2 groups: diuretic resistant groups (those with 24 hours urinary sodium less 78 mEq) and diuretic sensitive group (with 24 hours urinary sodium more thatn 78 mEq). Patients in diuretic resistant group were 24 patients (60%) and those in diuretic sensitive group were 16 patients (40%).
All the patients were subjected to full history taking, clinical examination, laboratory investigations including liver function tests, renal function tests, 24 hours urine sample (for measuring of sodium) and spot urine sample (for sodium, potassium and creatinine).
This study revealed highly significant correlation between 24 hours urinary sodium and spot urine sodium: potassium ratio with sensitivity 87.5%, specificity 87.5% and accuracy 87%.
Similar finding was noticed with spot urine sodium: creatinine ratio, as it showed highly significant correlation with 24 hours urinary sodium. This ratio showed sensitivity 81.3%, specificity 87.5% and accuracy 85%.
In addition, the present study showed more deterioration of liver function in diuretic resistant patients compared to diuretic sensitive patients. This was noticed in the form of higher Child Pugh score, higher INR, lower serum albumin, serum sodium and lower platelet count.