Liver cirrhosis
ICD-10 K74 · ICD-11 DB93.1
Liver Cirrhosis with Hypovolaemic Hyponatraemia (Serum Sodium Below 130 mmol/L) and No Ascites
Clinical Scenario
This protocol addresses patients with liver cirrhosis who develop hypovolaemic hyponatraemia — serum sodium below 130 mmol/L — in the absence of ascites and oedema.
Unlike the hypervolaemic form, hypovolaemic hyponatraemia in cirrhosis is frequently characterised by the absence of ascites and oedema. Recognising this distinction guides the management approach toward identifying and correcting the causative factor alongside plasma volume restoration.
Management Approach
The cornerstone of treatment involves addressing the underlying cause. Plasma volume expansion forms part of the approach — the complete structured regimen is available in the full protocol.
References
DOI: 10.1016/j.jhep.2018.03.024
- As opposed to hypervolaemic hyponatremia, hypovolaemic hyponatremia is characterised by the frequent absence of ascites and oedema.
- Hypovolaemic hyponatremia requires plasma volume expansion with saline solution and the correction of the causative factor.
- The removal of the cause and administration of normal saline are recommended in the management of hypovolemic hyponatremia (III;1).