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Abstract

STUDY OF CORRELATION OF UREA, CREATININE, SODIUM, POTASSIUM AND CHLORIDE CONCENTRATION BETWEEN ASCITIC FLUID AND VENOUS BLOOD IN ALCOHOLIC LIVER DISEASE

Dr. Sunanda Amonkar*, Dr. Sagar Badachi, Dr. Chitra Y. Dhume and Dr. Mitchelle Menezes

ABSTRACT

Treatment of ascitic cirrhosis requires monitoring of blood biochemistry. Regular blood sampling can become difficult in these patients due to their limited venous access. A direct measure of ascites could simplify the medical procedure. This strategy depends on an excellent correlation between venous blood and ascitic fluid levels of the various biochemical parameters monitored. Hence we have studied the correlation of urea, creatinine and electrolytes between ascitic fluid and venous blood in cirrhosis, both before diuretics and after initiating diuretics. The study was conducted in over a period of 24 months in Goa Medical College and Hospital. Diagnosis and classification of cirrhosis was made based on Childpugh Classification and signs and symptoms like swelling of abdomen, asterixis, gynaecomastia, spider angioma, palmar, erythema, duputryen contracture, pedal edema, jaundice, parotid swelling, inversion of sleep rhythm, past history of melena, past history of hematemesis, anorexia, weakness and pallor. Two hundred concomitant ascitic fluid and blood samples were obtained from 100 patients, at first visit (before diuretic therapy) and after initiating diuretic therapy. In ascetic fluid and blood of cirrhotic patients at first visit the results were respectively 28.41±6.943 and 29.43±6.958 for Urea (r=0.984, p<0.0001), 0.919±0.2145 and 1.022±0.2205 for creatinine (r=0.829, p<0.0001), 133.87 ± 4.136 and 131.88±4.083 for Na(r=0.968, p<0.0001), 3.994±0.5158 and 4.061±0.5162 for K(r=0.961, p<0.0001), 105.59±5.932 and 102.98±6.055for Cl (0.980, p<0.0001). After initiating diuretic therapy, the results in ascitic fluid and blood were, respectively 28±6.515 and 28.66±6.643 for urea (r=0.993, p<0.0001), 0.941±0.1826 and 1.023±0.1791 for creatinine (r=0.845, p<0.0001), 133.79±3.301 and 131.87±3.199 for Na (r=0.953, p<0.0001), 4.064±0.4679 and 4.128±0.4513 for K (r=0.965, p<0.0001) and 106.03±5.355 and 105.52±5.194 for Cl (r=0.965, p<0.0001) thereby concluding the strong correlation for Na, K, Cl, Urea, and Creatinine between ascitic fluid and venous blood in cirrhotic patients and also a strong correlation for Na, K, Cl, Urea, and Creatinine are strong between ascites and venous blood in cirrhotic patients both before diuretics and after initiating diuretics.

Keywords: Cirrhosis, Acites, Diuretic, Paracentesis.


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