Related Experiment Videos
Renal Dysfunction and Serum Sodium-Based Risk Stratification for In-Hospital Mortality in Liver Cirrhosis
Sonja Golubović1,2, Božidar Dejanović2,3, Dimitrije Damjanov2,3
1Clinic for Nephrology and Clinical Immunology, University Clinical Center of Vojvodina, 21000 Novi Sad, Serbia.
Medicina (Kaunas, Lithuania)
|July 28, 2026
Summary
Kidney dysfunction and low serum sodium levels in liver cirrhosis patients predict in-hospital mortality. A simple creatinine-sodium score offers practical bedside risk stratification, complementing existing models.
Area of Science:
- Nephrology
- Hepatology
- Internal Medicine
Background:
- Kidney dysfunction and hyponatremia are common in decompensated liver cirrhosis, worsening patient prognosis.
- Current prognostic tools for cirrhosis are often liver-centric and require numerous variables.
- There is a need for accessible prognostic models focusing on kidney function and serum sodium.
Purpose of the Study:
- To develop and evaluate prognostic models for in-hospital mortality in liver cirrhosis patients.
- To assess the predictive value of kidney function and serum sodium levels.
- To compare these novel models against established scoring systems like MELD and Child-Pugh.
Main Methods:
- Retrospective single-center cohort study of 547 hospitalized liver cirrhosis patients.
- Data collected included serum urea, creatinine, sodium, age, sex, and in-hospital outcome.
- Kidney function assessed using estimated glomerular filtration rate (eGFR) via CKD-EPI 2021 equation; models compared using AUC, calibration, and operating characteristics.
Main Results:
- In-hospital mortality occurred in 26.9% of patients (147/547).
- Lower eGFR, higher urea, and lower serum sodium independently predicted mortality.
- A simple creatinine-sodium score showed moderate discrimination (AUC 0.681), stratifying mortality risk effectively.
Conclusions:
- Kidney dysfunction and hyponatremia are independent predictors of in-hospital mortality in liver cirrhosis.
- A straightforward creatinine-sodium score can aid bedside risk stratification.
- This score may enhance routine clinical assessment alongside MELD-based evaluations.
Related Concept Videos
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
01:22Acute Kidney Injury I: Introduction
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
01:22Acute Kidney Injury VI: Nursing Management
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
01:24Serum Studies: Renal Function Tests
Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.