Serum Electrolyte and Acid–Base Abnormalities in Hepatic Encephalopathy Associated with Chronic Liver Disease

Abstract

Background: Hepatic encephalopathy (HE) is a severe neuropsychiatric complication of chronic liver disease (CLD) frequently associated with electrolyte and acid–base disturbances that may worsen disease severity and prognosis.

Aim: To evaluate serum electrolyte and acid–base abnormalities in patients with hepatic encephalopathy associated with chronic liver disease and assess their correlation with disease severity and outcomes.

Materials and Methods: This prospective observational study was conducted in the Department of General Medicine, Baba Raghav Das Medical College and Nehru Hospital, Gorakhpur, Uttar Pradesh, from January to December 2024. A total of 115 adult patients with hepatic encephalopathy associated with chronic liver disease were included. Hepatic encephalopathy was graded using the West Haven criteria. Serum sodium, potassium, calcium, and arterial pH were measured at admission and discharge. Statistical analysis was performed using SPSS version26.0.

Results: Most patients belonged to the 41–50 year’s age group (30.4%) and all were male. Alcohol-induced decompensated chronic liver disease was the predominant etiology (78.3%). Grade 2 HE was most common (37.4%). Significant associations were observed between etiology and diagnosis (p=0.005), admission calcium (p=0.009), admission pH (p=0.017), and all discharge biochemical parameters. Overall, 79.1% improved, while20.9% expired.

Conclusion: Electrolyte and acid–base abnormalities are important biochemical disturbances in hepatic encephalopathy. Early recognition, routine biochemical monitoring, and prompt management are essential to improve outcomes and reduce mortality.