liver cirrhosis, hyperaldosteronism, and sodium retention

[GingerSue]

When a person has liver cirrhosis, the liver fails to metabolize aldosterone adequately, and the result is hyperaldosteronism with sodium and water retention

In my book, there is this description, then a diagram of the human body with systemic clinical manifestations:

Metabolic: potassium deficiency, hyponatremia, and hypoalbuminemia

If there is sodium retention, then why is it "hyponatremia"?

[Beary-nice]

The only explaination I can think of is that an excess of sodium would result also in an excess of water. Dilution would occur resulting in hyponatremia.

[GingerSue]

could be

[deeDawntee, RN]

Hello,

Great question! I did some research on-line and the following website is indicative of what most of them say about sodium (if they mention it at all), they describe a mild elevation in sodium. However, I do believe that your text book is inaccurate, because nowhere in the 20 or so articles I looked at did hyponatremia come up as a sign.

http://endocrine-disorders.health-cares.net/conns-syndrome-symptoms.php

"Mild hypernatremia (high blood sodium), hypokalemia (low blood potassium), hyperkaluria (high urine potassium) and high levels of alkalinity are the electrolyte abnormalities commonly seen with excess aldosterone."

[MikeyJ, RN]

I actually have seen first hand knowledge of this because my aunt passed away from liver failure due to long-term alcohol abuse, and I was her primary care taker for 6 months.

During her many stays at the hospital from her failing liver, she developed hyponatremia quite often. The physician's had told me that in end-stage liver cirrhosis, their is renal damage because of the reduced blood flow to the kidney's. As we all know, the kidneys are imperative in regulation of water in our body. So I know my aunt has hyponatremia due to excess water in her system. And if anyone has ever seen a cirrhotic patient first-hand, you would notice the extreme edema and ascites due to fluid retention secondary to liver failure and renal failure.

However, I do know that hepatorenal syndrome (renal failure due to decreased blood flow secondary to liver cirrhosis/failure) usually occurs during the end stage.

[deeDawntee, RN]

I actually have seen first hand knowledge of this because my aunt passed away from liver failure due to long-term alcohol abuse, and I was her primary care taker for 6 months.

During her many stays at the hospital from her failing liver, she developed hyponatremia quite often. The physician's had told me that in end-stage liver cirrhosis, their is renal damage because of the reduced blood flow to the kidney's. As we all know, the kidneys are imperative in regulation of water in our body. So I know my aunt has hyponatremia due to excess water in her system. And if anyone has ever seen a cirrhotic patient first-hand, you would notice the extreme edema and ascites due to fluid retention secondary to liver failure and renal failure.

However, I do know that hepatorenal syndrome (renal failure due to decreased blood flow secondary to liver cirrhosis/failure) usually occurs during the end stage.

I am soooo sorry to hear that. That sounds brutal. What a horrible way to know the pathophysiology of a disease.

:icon_hug::icon_hug:

To the OP, you may want to ask your Prof. Looks like the sodium could go either way, depending on the stage of the disease and severity of the ascites.

[carolinapooh, BSN, RN]

The only explaination I can think of is that an excess of sodium would result also in an excess of water. Dilution would occur resulting in hyponatremia.

This is exactly what my book says. (Lemone and Burke, p. 589)

"Serum electrolytes are measured. Hyponatremia is common, due to hemodilution."

They are indeed retaining salt, but dilution causes serum levels to be low.