Impacts of salt restriction on nutritional status, sarcopenia, and mortality of cirrhotic patients with ascites
Abstract Background Salt restriction is a cornerstone in managing ascites in cirrhotic patients; however, its impact on nutritional status, sarcopenia, and mortality remains unclear. Aim To evaluate the effects of a salt-restricted diet (SRD) on ascites control, body composition, sarcopenia developm...
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BMC
2025-07-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-025-03830-1 |
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| author | Maha Elsabaawy Mohammed Ragab Madiha Naguib Eman Kamal Maymona Al-Khalifa Khaled Gamil Marwa Elfayoumy |
| author_facet | Maha Elsabaawy Mohammed Ragab Madiha Naguib Eman Kamal Maymona Al-Khalifa Khaled Gamil Marwa Elfayoumy |
| author_sort | Maha Elsabaawy |
| collection | DOAJ |
| description | Abstract Background Salt restriction is a cornerstone in managing ascites in cirrhotic patients; however, its impact on nutritional status, sarcopenia, and mortality remains unclear. Aim To evaluate the effects of a salt-restricted diet (SRD) on ascites control, body composition, sarcopenia development, and patient survival in cirrhotic patients with decompensated liver disease. Methods This prospective study included 102 patients with grade III ascites, categorized into two groups based on dietary adherence: Salt-Restricted Diet (SRD), (n = 46) and Salt-Unrestricted Diet (SUD) (n = 56). Sodium intake was assessed using the Dietary Sodium Restriction Questionnaire (DSRQ) and spot urine Na/K ratio. Nutritional status, sarcopenia, ascites control, and six-month mortality were evaluated. Results The SRD group showed better ascites control, with fewer paracentesis sessions per month (1.57 ± 0.65 vs. 4.07 ± 1.43, p < 0.001). Sarcopenia was more prevalent in the SRD group (p < 0.001), with lower SMI (4.88 ± 7.13 vs. 16.7 ± 544.8, p < 0.001) and TR PMM (19.03 ± 3.68 vs. 71.92 ± 191.9, p < 0.001). Higher nutritional risk was significantly associated with SRD (p = 0.001). Mortality was significantly higher in the SRD group (67.4%) compared to the SUD group (35.7%), p = 0.001. Multivariate analysis identified sarcopenia (OR = 2.684, p = 0.006) and SRD (OR = 1.65, p < 0.001) as independent predictors of mortality. Conclusion While effective in ascites control, sodium restriction may compromise nutritional status, heighten sarcopenia risk, and increase mortality, highlighting the need for a more individualized dietary approach. |
| format | Article |
| id | doaj-art-c115ec8bdbb44cf0814eff1e706da1ec |
| institution | Kabale University |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj-art-c115ec8bdbb44cf0814eff1e706da1ec2025-08-20T03:42:57ZengBMCBMC Gastroenterology1471-230X2025-07-0125111110.1186/s12876-025-03830-1Impacts of salt restriction on nutritional status, sarcopenia, and mortality of cirrhotic patients with ascitesMaha Elsabaawy0Mohammed Ragab1Madiha Naguib2Eman Kamal3Maymona Al-Khalifa4Khaled Gamil5Marwa Elfayoumy6Hepatology and Gastroenterology Department, National Liver Institute Minufiya UniversityHepatology and Gastroenterology Department, National Liver Institute Minufiya UniversityHepatology and Gastroenterology Department, National Liver Institute Minufiya UniversityAnesthesia and Intensive Care Nutrition Department, National Liver Institute Menoufia UniversityTherapeutic Nutrition Department, National Liver Institute Menoufia UniversityHepatology and Gastroenterology Department, National Liver Institute Minufiya UniversityHepatology and Gastroenterology Department, National Liver Institute Minufiya UniversityAbstract Background Salt restriction is a cornerstone in managing ascites in cirrhotic patients; however, its impact on nutritional status, sarcopenia, and mortality remains unclear. Aim To evaluate the effects of a salt-restricted diet (SRD) on ascites control, body composition, sarcopenia development, and patient survival in cirrhotic patients with decompensated liver disease. Methods This prospective study included 102 patients with grade III ascites, categorized into two groups based on dietary adherence: Salt-Restricted Diet (SRD), (n = 46) and Salt-Unrestricted Diet (SUD) (n = 56). Sodium intake was assessed using the Dietary Sodium Restriction Questionnaire (DSRQ) and spot urine Na/K ratio. Nutritional status, sarcopenia, ascites control, and six-month mortality were evaluated. Results The SRD group showed better ascites control, with fewer paracentesis sessions per month (1.57 ± 0.65 vs. 4.07 ± 1.43, p < 0.001). Sarcopenia was more prevalent in the SRD group (p < 0.001), with lower SMI (4.88 ± 7.13 vs. 16.7 ± 544.8, p < 0.001) and TR PMM (19.03 ± 3.68 vs. 71.92 ± 191.9, p < 0.001). Higher nutritional risk was significantly associated with SRD (p = 0.001). Mortality was significantly higher in the SRD group (67.4%) compared to the SUD group (35.7%), p = 0.001. Multivariate analysis identified sarcopenia (OR = 2.684, p = 0.006) and SRD (OR = 1.65, p < 0.001) as independent predictors of mortality. Conclusion While effective in ascites control, sodium restriction may compromise nutritional status, heighten sarcopenia risk, and increase mortality, highlighting the need for a more individualized dietary approach.https://doi.org/10.1186/s12876-025-03830-1CirrhosisAscitesSalt restrictionNutritional statusMalnutritionSodium intake |
| spellingShingle | Maha Elsabaawy Mohammed Ragab Madiha Naguib Eman Kamal Maymona Al-Khalifa Khaled Gamil Marwa Elfayoumy Impacts of salt restriction on nutritional status, sarcopenia, and mortality of cirrhotic patients with ascites BMC Gastroenterology Cirrhosis Ascites Salt restriction Nutritional status Malnutrition Sodium intake |
| title | Impacts of salt restriction on nutritional status, sarcopenia, and mortality of cirrhotic patients with ascites |
| title_full | Impacts of salt restriction on nutritional status, sarcopenia, and mortality of cirrhotic patients with ascites |
| title_fullStr | Impacts of salt restriction on nutritional status, sarcopenia, and mortality of cirrhotic patients with ascites |
| title_full_unstemmed | Impacts of salt restriction on nutritional status, sarcopenia, and mortality of cirrhotic patients with ascites |
| title_short | Impacts of salt restriction on nutritional status, sarcopenia, and mortality of cirrhotic patients with ascites |
| title_sort | impacts of salt restriction on nutritional status sarcopenia and mortality of cirrhotic patients with ascites |
| topic | Cirrhosis Ascites Salt restriction Nutritional status Malnutrition Sodium intake |
| url | https://doi.org/10.1186/s12876-025-03830-1 |
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