Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Aug 7, 2009; 15(29): 3631-3635
Published online Aug 7, 2009. doi: 10.3748/wjg.15.3631
Spot urinary sodium for assessing dietary sodium restriction in cirrhotic ascites
Mohammed Abdelhamid El-Bokl, Bahaa Eldeen Senousy, Khaled Zakaria El-Karmouty, Inas El-Khedr Mohammed, Sherif Monier Mohammed, Sherif Sadek Shabana, Hassan Shalaby
Mohammed Abdelhamid El-Bokl, Bahaa Eldeen Senousy, Khaled Zakaria El-Karmouty, Inas El-Khedr Mohammed, Sherif Monier Mohammed, Sherif Sadek Shabana, Hassan Shalaby, Department of Gastroenterology and Hepatology, Ain Shams University school of Medicine, Abbassia 11566, Cairo, Egypt
Author contributions: El-Bokl MA designed the study and research protocol; Senousy BE performed the data collection and literature search and wrote the initial manuscript; El-Karmouty KZ and Mohammed IEK analyzed and reviewed the data and edited the manuscript; Mohammed SM, Shabana SS and Shalaby H analyzed the data and reviewed the final manuscript.
Correspondence to: Dr. Bahaa Eldeen Senousy, BSc, Department of Gastroenterology and Hepatology, Ain Shams University school of Medicine, Abbassia 11566, Cairo, Egypt. bahaa_senousy@yahoo.co.uk
Telephone: +20-10-1804903
Fax: +20-2-6835511
Received: March 26, 2009
Revised: June 22, 2009
Accepted: June 29, 2009
Published online: August 7, 2009
Abstract

AIM: To evaluate the accuracy of spot urinary Na/K and Na/creatinine (Cr) ratios as an alternative to 24-h urinary sodium in monitoring dietary compliance in patients with liver cirrhosis and ascites treated with diuretics.

METHODS: The study was carried on 40 patients with liver cirrhosis and ascites treated with diuretic therapy. Patients were divided into two groups according to 24-h urinary sodium. We measured spot urine Na/K ratio, Na/Cr ratio and 24-h urinary sodium. Student’s t test was used to compare the interval variables and χ2 test to compare the nominal variables between the two groups. Receiver operator characteristic curve was used to identify the best cutoff point for Na/K and Na/Cr ratio.

RESULTS: The best cutoff point for Na/K ratio was 2.5 (P < 0.001) and area under the curve (AUC) was 0.9, and for Na/Cr ratio, the best cutoff point was 35 (P < 0.001) and AUC was 0.885. Na/K ratio showed higher sensitivity and accuracy compared to Na/Cr ratio (87.5% and 87% for Na/K ratio; 81% and 85% for Na/Cr ratio, respectively).

CONCLUSION: Spot urine Na/K ratio has adequate accuracy for assessment of dietary sodium restriction compared with 24-h urinary sodium in patients with liver cirrhosis and ascites.

Keywords: Ascites; Liver cirrhosis; Portal hypertension; Urinary sodium