الفهرس 
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Abstract
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.
The aim of this study is to evaluate 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.
This study was carried out on 40 patients presenting with liver cirrhosis and ascites, admitted at Ain Shams University Hospitals and Ahmed Maher teaching hospital.
All the patients were subjected to full history taking, clinical examination, laboratory investigations including liver function tests, renal function tests, 24 hours urine sample (for measuring of sodium) and spot urine sample (for sodium and potassium ).
The studied patients were divided into 2 groups: diuretic resistant groups (those with 24 hours urinary sodium < 78 mEq) and diuretic sensitive group (with 24 hours urinary sodium > 78 mEq). Patients in diuretic resistant group were 8 patients (20%) and those in diuretic sensitive group were 32 patients (80%).
The present study showed more deterioration of liver function in diuretic resistant patients compared to diuretic sensitive patients. This was noticed in the form of higher Child Pugh score, higher INR, higher billirubin, and lower serum albumin.
This study revealed highly significant correlation between 24 hours urinary sodium and spot urine sodium/potassium ratio with sensitivity 68.8%, specificity 87.5% and accuracy 72% at cutoff point of 1.5.
So in conclusion random urine Na/K >1.5 is an accurate cost effective, convenient method for replacing 24 hours urinary Na for evaluating diuretic response.