RESEARCH Hyponatremia influences e

Full list of author information is available at the end of the articleIntroduction Patients with advanced cirrhosis commonly develop a functional renal impairment that render the kidney sus-ceptible to retain sodium and solute-free water. In some patients, there is disproportionate retention of water rela-tive to sodium, which leads to a dilutional state where water is retained out of proportion to sodium causing hyponatremia and hypoosmolality. Although hyponatre-mia in patients without end-stage liver disease is defined by serum sodium concentration <135 mEq/L, in cirrhosis it is defined as a serum sodium concentration of less than 130 mEq/L in the presence of ascites or edema [1-3]. In the majority of patients hyponatremia occurs in close as-sociation with an impairment of renal function and corre-lates with poor prognosis. In patients with cirrhosis and ascites, the five-year probability of developing hyponatre-mia is 37 % with a 25 % probability of survival at one year [4]. Hyponatremia is also an important marker of progno