ABSTRACT
Background: The purpose of study was to determine the role of salt intake in the management of ascites. Ascites is the most common complication of cirrhosis. Dilutional hyponatremia is present in most of patients with ascites. It is due to excess in antidiuretic hormone which occurs due to decrease in effective arterial volume. Water free salt intake tends to maintain the circulatory volume by drawing the fluid from third space, hence inhibiting ADH. It also increases the response of diuretics by increasing the filtered load of sodium. On the other hand, strict salt restriction and diuretics worsen the hyponatremia and make ascites refractory to treatment
Objective: To determine the role of salt intake in the management of ascites in cirrhotic patients
Methods: It was an interventional experimental study. This study was conducted in Services Hospital, Lahore. Sixty cirrhotic patients with ascites were randomized into two groups to undergo treatment with diuretics and salt restriction during the day. One group [A] was advised salt intake at night with over night fluid restriction, and the other group observed 24 hour salt restriction. The comparison was done in respect to average reduction in weight and abdominal girth over 9 days
Results: The average reduction in weight [p=0.011] and abdominal girth [p=0.003] was significantly more in patients taking salt at night. Moreover these patients also maintained their serum sodium levels [p=0.00001] and majority of them did not need increase in the dose of diuretics or therapeutic ascitic tap
Conclusion: Correction of dilutional hyponatremia by water free salt intake to improve the response of diuretics, gives a safe and effective option for the management of ascites