Chronic liver disease poses a significant global health challenge, particularly in regions like Pakistan, where it is a major cause of morbidity and mortality. Hyponatremia, a common complication of advanced liver disease, has been associated with severe clinical outcomes. This study aims to investigate the frequency of hyponatremia among patients with chronic liver disease, providing local insights into its prevalence and associated factors.

The research, carried out in the Department of Medicine, Khyber Teaching Hospital, Peshawar, used a cross sectional and descriptive design for a duration of six months, starting from February 25, 2017, and ending on August 25, 2017. Detailed history and examinations, along with Child-Pugh Scores, were employed to assess liver disease severity. Blood samples, collected under strict aseptic conditions, were analyzed for hyponatremia by a pathologist. Strict exclusion criteria were implemented to enhance result reliability.

Among the 130 patients, with a mean age of 38 years and a male predominance (68%), hyponatremia was

observed in 65% of cases. The distribution across age groups, gender, duration of chronic liver disease, Child-Pugh class, and hepatic encephalopathy did not exhibit statistically significant variations in hyponatremia prevalence (p > 0.05). Notably, the study identified a substantial proportion of patients with moderate liver disease severity (Child-Pugh Class B - 59%).

This study concludes that hyponatremia is a prevalent complication in patients with chronic liver disease, affecting most cases in the studied population. The lack of significant associations with demographic and clinical factors (p > 0.05) suggests the complexity of hyponatremia's interplay in this context. While aligning with some literature,

disparities emphasize the need for nuanced interpretations and ongoing research to unravel the intricacies of hyponatremia in chronic liver disease.