Sodium and Calcium Levels as a Predictor for Hepatic Encephalopathy in Pediatric Patients with Chronic Liver Disease

Background: Chronic liver disease (CLD) in children is a growing health problem with significant morbidity and mortality. There is a specific susceptibility to electrolyte imbalance in chronic liver disease patients that can deteriorate their condition to hepatic encephalopathy. The aim of this study is to evaluate the electrolyte disturbance in CLD patients with and without hepatic encephalopathy.Methods: This cross-sectional study was conducted in Ghaem Hospital, Mashhad University of Medical Sciences, Iran, during a six-year period. All patients below 14 years of age with chronic liver disease admitted to the pediatric gastroenterology department were included. Demographic data, laboratory tests, clinical manifestations and presence of hepatic encephalopathy were recorded in a checklist for each patient. Data was entered in SPSS software version 20. Qualitative data were analyzed using chi-square, and quantitative data were analyzed using independent t-tests. A Pvalue 0.05 was considered significant. Results: Our study on 85 CLD patients showed that the serum sodium level and serum calcium level were significantly lower in patients with hepatic encephalopathy with P-Values of 0.001 and 0.02, respectively. Also, serum urea and bilirubinemia levels were significantly higher in the patients with hepatic encephalopathy with P-Values of 0.03 and 0.001 respectively. Conclusion: It seems that reducing serum sodium and calcium level can be predictive of hepatic encephalopathy in pediatric patients with chronic liver disease