Hyponatremia occurs when sodium levels in the body are below the typical level. It may develop in people living with cirrhosis, which is when scar tissue develops on the liver and replaces healthy tissue.
A person has hyponatremia if their serum sodium concentration level is
Sodium is a type of electrolyte. Electrolytes conduct electricity when dissolved in water. They are vital for several functions in the body.
Hyponatremia is the most common electrolyte disorder, affecting approximately
People with cirrhosis have permanent liver damage as a result of scarring, which
Researchers estimate cirrhosis affects around
This article discusses the symptoms, causes, treatment, and outlook for people with hyponatremia in cirrhosis. It also explores when someone should talk with a doctor.
Symptoms of hyponatremia in cirrhosis vary depending on the severity of the condition but
- loss of appetite
- muscle cramps
- altered mental status
If a person has mild hyponatremia, they may not notice any symptoms.
Additionally, there is some crossover between the
- feeling tired
Other early symptoms of cirrhosis may include:
- unintentional weight loss
- poor appetite
- mild pain or discomfort in the upper right side of the abdomen
A person may develop cirrhosis for many reasons. The
In turn, cirrhosis
When cirrhosis becomes severe, the scarring on the liver can make it difficult for the blood to enter the liver through the portal vein. This leads to high blood pressure in the portal vein, which healthcare professionals call portal hypertension.
This type of hypertension can also lead to a condition called ascites. It is the
This means sodium levels in a person’s blood may become increasingly diluted until they develop hyponatremia.
Additionally, the progression of ascites and cirrhosis can lead to a decline in kidney function. The kidneys are responsible for a range of bodily processes, which include balancing electrolyte and fluid levels.
Other common causes of hyponatremia that a person with cirrhosis may also experience include:
- Kidney failure: Kidney failure may occur as kidney function declines and the kidneys cannot filter extra fluid from the body.
- Congestive heart failure: A buildup of excess fluid in the body is one symptom of congestive heart failure.
- Taking diuretics: These medications cause the body to release more sodium in the urine.
- Taking antidepressants and pain medication: These medications may increase the amount a person sweats or urinates, causing a loss of sodium and fluid.
- Severe vomiting or diarrhea: The body loses a lot of fluid and sodium with severe vomiting and diarrhea.
- Excessive thirst: If a person drinks too much water, the fluid levels in their body increase, which can lead to a sodium imbalance.
There are several treatment options for hyponatremia depending on its cause and a person’s fluid status. Healthcare professionals aim to balance the water and sodium levels in the blood during treatment.
Other treatments for hyponatremia in cirrhosis may include:
- Intravenous (IV) albumin infusion: A doctor may administer an albumin infusion through a vein to help temporarily expand the circulatory volume. This is the amount of fluid traveling through the cardiovascular system. Albumin is a protein that binds substances to help them travel through the bloodstream.
- IV or oral potassium: Because potassium acts similarly to sodium as an electrolyte, administering potassium may also help increase someone’s sodium levels.
- Vasopressin 2 receptor antagonists: This medication helps the kidneys remove large amounts of water through urine without reducing sodium, thus increasing serum sodium levels.
Doctors may administer hypertonic saline in certain situations. Healthcare professionals define hypertonic saline as any solution of sodium chloride (NaCl) in water with a concentration of NaCl higher than
Experts do not recommend hypertonic saline as a long-term treatment for hyponatremia because it can lead to ascites and edema, or swelling due to fluid retention.
A person with advanced liver disease complicated with hyponatremia may require a liver transplant.
A person’s outlook depends on their individual circumstances, including:
- severity of hyponatremia
- severity of cirrhosis
- overall health and whether they have other health conditions
People may also respond differently to treatments. Some may respond to IV infusions and medications but others may require a liver transplant.
A person can talk with their doctor to learn more about their outlook.
A person should visit a doctor if they experience any symptoms of hyponatremia or cirrhosis. With both conditions, a person may not notice any symptoms in the early stages or until the condition
Therefore, people may benefit from regularly visiting a doctor to monitor their health. This is particularly recommended if they have any of the following conditions that are common causes of cirrhosis:
- nonalcoholic fatty liver disease
- alcoholic liver disease
- chronic hepatitis B
- chronic hepatitis C
A person can also talk with a healthcare professional if they notice any new or worsening symptoms, or if they notice any symptoms after taking medications, such as diuretics.
Hyponatremia is the
Treating hyponatremia in cirrhosis involves correcting the fluid and sodium imbalance in the body. A healthcare professional may administer medications or nutrients, like potassium, to help achieve this. Some people may require a liver transplant to treat severe cirrhosis.
A person with hyponatremia in cirrhosis should speak with their doctor about their individual outlook and treatment options.