hyponatremia

[dgbeam]

Dr.Schiano,
   I'm waiting for transplant with a relatively low MELD of 11.
   I read a article recently referring to the fact that Patients with hyponatremia had a higher mortality rate and that UNOS was considering adding sodium levels to the MELD calculation.
   I also found a MELD  calculator that includes sodium at the mayo clinic site

http://www.mayoclinic.org/meld/mayomodel8.html

  My sodium level averages from 128 to 130 and the MELD-NA Calculator gives me a much higher MELD of 20.
  Are they thinking of changing the MELD calculation?
  Should I be concerned about the hyponatremia?
  Gail

[ClippedWings]

I just found out that I was awarded an exepmtion to hyponatremia.  UNOS gave me 7 additional MELD points for the low sodium.  Hope it helps accelerate things as I have been hospitalized 3 times in the past month for dangerously low sodium levels.  Good luck to you.

[Thomas D Schiano, MD]

patients who have hyponatremia typically have more severe liver disease than their MELD scores suggest.  We are not close to adoption of a MELD-Na system nationally.  patients often have problems with ascites and renal dysfunction.

[ClippedWings]

I'm currently listed with a MELD of 21 and frequent bouts of hyponatremia.  My transplant center has applied to UNOS for a MELD exception for the low sodium levels, but told me exemptions are rare except in cases involving HCC. My sodium levels have recently been as low as 115 which required hospitalization and treatment.  Good luck to you, I'll let you know if I get an exemption.