AIM:To evaluate the accuracy of spot urinary Na/K and Na/creatinine (Cr) ratios as an alternative to 24-h urinary sodium in monitoring dietary compliance in patients with liver cirrhosis and ascites treated with diuretics. METHODS:The study was carried on 40 patients with liver cirrhosis and ascites treated with diuretic therapy. Patients were divided into two groups according to 24-h urinary sodium. We measured spot urine Na/K ratio, Na/ Cr ratio and 24-h urinary sodium. Student's t test was used to compare the interval variables and χ 2 test to compare the nominal variables between the two groups. Receiver operator characteristic curve was used to identify the best cutoff point for Na/K and Na/Cr ratio. RESULTS:The best cutoff point for Na/K ratio was 2.5 (P < 0.001) and area under the curve (AUC) was 0.9, and for Na/Cr ratio, the best cutoff point was 35 (P < 0.001) and AUC was 0.885. Na/K ratio showed higher sensitivity and accuracy compared to Na/Cr ratio (87.5% and 87% for Na/K ratio; 81% and 85% for Na/Cr ratio, respectively). CONCLUSION:Spot urine Na/K ratio has adequate accuracy for assessment of dietary sodium restriction compared with 24-h urinary sodium in patients with liver cirrhosis and ascites.

Background: Scarring or progressive fibrosis and cirrhosis develop over time as a result of chronic viral infection, which induces inflammation and tissue healing via deposition of extracellular matrix. There has been an increase in the sustained virological response (SVR) and the rate of eradication of HCV because of the effectiveness of directacting antiviral drugs (DAAs). Reduced hepatic fibrosis is associated with increased SVR rates. There are a variety of non-invasive fibrosis imaging, scoring, and marker methods: transient elastography, aminotransferase platelet ratio index (APRI), as well as fibrosis-4 (FIB-4) score. Objective: The purpose of this research was comparing the novel fibrosis index to APRI, (FIB-4) score and fibroscan in predicting the degree of hepatic fibrosis in Egyptian chronic HCV patients who were managed by DAAs. Patients and methods: 100 Egyptians with chronic HCV infection participated in a our 3-month long prospective Cohort research using the IFN-free DAA combination of Sofosbuvir and Daclatasvir ± Ribavirin. Results: There was significant regression of fibrosis with DAAs treatment in all patients achieving SVR by fibroscan, APRI and fib4. Novel fibrosis index is reliable and good tool in estimation of liver fibrosis in correlation to fibroscan, with the cutoff value in prediction of hepatic fibrosis stage 4 was >3.1 and has sensitivity of 81.5% while the specificity was 74.1%. Conclusion Novel fibrosis index has been found to be good reliable marker for assessment of liver fibrosis with high accuracy of predicting f4 fibrosis stage. There was significant marked reduction of fibrosis degree by fibroscan, APRI and FIB4 after DAAs treatment.

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