Diagnostic Usefulness of the Random Urine Na / K Ratio in Predicting Therapeutic Response for Diuretics in Cirrhotic Patients with Ascites

Ascites is a major complication of liver cirrhosis which carries a poor prognosis. Diuretics are used in treatment of ascites in addition to salt restriction. Monitoring of diuretic response can be achieved by measurement of 24 hours urinary sodium. This study evaluated the accuracy of using spot urinary sodium/potassium ratio as a reliable alternative to 24 hours urinary sodium in assessment of dietary sodium compliance in patients with liver cirrhosis receiving diuretics. Fifty patients presented with liver cirrhosis and ascites were divided into 2 groups: GI 14 (28%) patients diuretic resistant with 24 hours urinary sodium < 78 mEq) and GII 36 (72%) patients diuretic sensitive with 24 hours urinary sodium > 78 mEq. The results showed highly significant correlation between 24 hours urinary sodium and spot urine sodium/potassium ratio with sensitivity 87.5% specificity 56% and accuracy 70% at cutoff point of 1.8.