Spot urinary sodium for assessing dietary sodium restriction in cirrhotic ascites

Table 1 Patients characteristics (mean ± SD)

	Diuretic-resistant group (n = 24)	Diuretic-sensitive group (n = 16)	P
Age (yr)	50 ± 4	49 ± 4	NS
Sex ratio (Male/female)	17/7	11/5	NS
Weight loss (yes/no)	0/24	9/7	0.001
Serum creatinine (mg/dL)	1.1 ± 0.2	0.9 ± 0.2	NS
BUN (mg/dL)	23.5 ± 8.3	18.5 ± 8.3	0.033
Serum sodium (mEq/L)	128 ± 5	136 ± 5	0.001
Serum potassium (mEq/L)	4.3 ± 0.6	4.3 ± 0.5	NS
AST (U/L)	68 ± 34	69 ± 40	NS
ALT (U/L)	56 ± 27	57 ± 27	NS
ALP (U/L)	283 ± 56	246 ± 84	NS
Total bilirubin (mg/dL)	3.8 ± 1.7	3.2 ± 1.8	NS
Direct bilirubin (mg/dL)	1.9 ± 1.1	1.6 ± 0.9	NS
Total proteins (g/dL)	7.1 ± 0.4	7.2 ± 0.5	NS
Serum albumin (g/dL)	2.4 ± 0.4	2.8 ± 0.4	0.012
WBC count (× 109/L)	6.6 ± 2.4	8.8 ± 4.3	0.045
Hemoglobin (g/dL)	9.7 ± 1.7	9.5 ± 2.6	NS
Platelet count (× 109/L)	73 ± 24	108 ± 58	0.014
INR	2.9 ± 1.3	1.5 ± 0.2	NS
PTT (s)	36 ± 9	32 ± 7	NS
Child classification (B/C)	1/23	6/10	0.011

AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; NS: Not significant.

Table 2 Difference between groups as regards 24-h urinary sodium and spot urine ratios (mean ± SD)

	Diuretic-resistant group (n = 24)	Diuretic-sensitive group (n = 16)	P
24 h urinary sodium (mEq)	33 ± 19	126 ± 46	0.001
Spot urine Na/K ratio	1.3 ± 1.3	3.7 ± 1.6	0.001
Spot urine Na/Cr ratio	21 ± 18	100 ± 87	0.001

Table 3 Sensitivity and specificity of different Na/K and Na/Cr ratios in determination of diuretic resistance or sensitivity

	Ratio	Sens (%)	Spec (%)	PPV (%)	NPV (%)	Acc (%)
Na/K ratio	1	93.8	58.3	76.7	90.0	80.0
	2.5	87.5	87.5	91.3	82.4	87
	3.5	50	95.8	92.3	55.6	67.5
Na/Cr ratio	20	93.8	66.7	82.1	91.7	85.0
	35	81	87.5	91	77.8	85.0
	45	62.5	87.5	88.2	60.9	72.5

PPV: Positive predictive value; NPV: Negative predictive value; Sens: Sensitivity; Spec: Specificity; Acc: Accuracy.