Abstract

A PROSPECTIVE OBSERVATIONAL STUDY ON ASSESSMENT OF SALT INTAKE PATTERN AND SEVERITY IN ASCITES PATIENTS WITH CIRRHOSIS OF LIVER ON DIURETIC THERAPY

Neerudu Keerthi*, Tigulla Laharika, Munde Pallavi, Pathipati Murali Krishna, A. V. Kishore Babu, P. N. Rao And A. Srinivasa Rao

ABSTRACT

Background: Ascites is defined as an abnormal accumulation of fluid in the peritoneal cavity. Ascites is the most common complication of cirrhosis, with approximately 50% of patients with compensated cirrhosis developing ascites over the course of 10 years. There are different types of salt which may differ in their sodium content. Some of them include commonly used table salt, rock salt, Himalayan pink salt, kosher salt, sea salt, celtic sea salt, fleur de sel, kala namak, flake salt, black Hawaiian salt, red Hawaiian salt, smoke salt, pickling salt. Monitoring dietary and drug compliance is an important aspect in treatment of ascites caused by cirrhosis of liver. Dietary sodium restriction is essential in mobilization of ascites patients in addition to diuretics. Monitoring is essential in patients who appear unresponsiveness to diuretics. Aim: To assess the pattern of salt intake and severity in ascites patients with cirrhosis of liver on diuretic therapy. Objectives: To assess the salt intake pattern in ascites patients with cirrhosis of liver on diuretics therapy. To assess the effect of type of salt on severity of ascites. To assess the severity scoring of ascites by using CPT scoring and MELD scoring. Materials and methodology: The study was conducted in the Hepatology department of Asian Institute of Gastroenterology, Gachibowli. This study says the severity of ascites with pattern of salt intake by using well defined questionnaires. The study was performed by four 5th-year pharm D students using validated assessment tools and severity assessment scoring systems. The patient disease severity was estimated with the help of Model for End Stage Liver Disease (MELD) score and Child- PUGH (CPT) score. Results: we noticed in 100 ascites patients that, the patients on salt restriction are not really restricted the salt to the target amount and that may be knowingly or unknowingly. By this even patients on diuretic drugs are also unresponsiveness to the therapy and the condition is getting worse, turning to refractory ascites. In our study we noticed that male patients (82%) were high in number and most of them were obese (59%). Based on etiology most of the patients were alcoholics (27%) followed by HBV (20%). Most of the patients were using table salt (52%) followed by rock salt (26%). We also noticed that most of the patients were taking salt greater than 2 grams per day (59%). Conclusion: Based on the study we noticed that most of the patients were moderately affected and 34% of the patients were severely affected. Through the questionnaire we concluded that severity of ascites is seen more in patients using salt greater than 2 grams per day and using table salt.

Keywords: Ascites, salt intake pattern, salt compliance, portal hypertension.