MELD) and (MELD-Na) Score as Predictors of Systemic Vascular Resistance in Cirrhosis in Patients with and without Renal Impairment)

Abstract

irrhosis is the end stage in the spectrum of chronic liver disease, characterized by advanced fibrosis and formation of regenerative nodules with distortion of underlying normal hepatic architecture (Heidlbaugh et al., 2006). Cirrhosis of the liver is more common than previously thought, affecting more than 633,000 adults yearly worldwide, according to a study published in (The Journal of Clinical Gastroenterology, 2015). There are multiple prognostic scores that predict the mortality from chronic liver disease, of which the Child-Pugh score and MELD score are the most commonly used. MELD is a validated scoring system used to predict mortality and is a composite of the patient‘s laboratory values for serum bilirubin and serum creatinine, and the international normalized ratio (INR) for prothrombin time (Younossi et al., 2014). The MELD score has been shown to be at least equivalent to the Child-Pugh score (Shaikh et al., 2010) in predicting survival of patients with cirrhosis. Hyponatremia is a common laboratory finding in patients with decompensated liver disease. It has been noted in several studies that inclusion of the serum sodium level, especially in hyponatremic patients, increases the predictive accuracy of MELD in chronic liver disease (Biselli et al., 2010). Hyponatremia mirrors the underlying primary