MELD Affected by Blood Sodium Levels Only?

Posted by wvcaregiver @wvcaregiver, Feb 21 6:14pm

My husband was diagnosed with cirrhosis in August during a surgery when ascites was discovered. The doctor performing the surgery said he has cirrhosis on the liver. In six months, his MELD has fluctuated between 8-16 based on bloodwork taken at various times, and using the MELD 3.0 calculator.

New bloodwork was conducted last Monday, and all numbers except sodium were within normal ranges. The sodium was low at 132, however he’s been told for months to eat reduced sodium. In November, the sodium blood level was 120 (critically low), however he was on an 800-1200 mg sodium diet then, which we followed daily.

When I ran the MELD score last night, it was a 10. However playing around with it, if I changed the sodium to 133, it went to 9; 134 to an 8; and 136 (in range), MELD dropped to a 6. When I decreased the MELD back to 120, the MELD went to 17. It surprised me that the blood sodium can cause the MELD to fluctuate so much. Has anyone else noticed this? We’re now on a 2,000 mg sodium diet, and typically get around 1600-1800 mg daily, so still working to increase it a little.

So I guess my questions:
1. What are your experiences with fluctuating MELD scores, and have you played around with the numbers to see how easily it can change?
2. What’s anyone’s experiences with diuretics? How did you know/When did you stop taking them if you did? Was it by doctor’s orders or did you just stop and see what happens?

Interested in more discussions like this? Go to the Liver Diseases Support Group.

Rosemary, Volunteer Mentor | @rosemarya | Feb 22 10:28am

@wvcaregiver, I am assuming that you are caregiver for your husband, and I want to welcome you to Connect. I know how confusing the medical language and lab results can be when diagnosed with a liver disease. I don't remember what my MELD scores were when I was first diagnosed, however my caregiver husband did keep track. I chose to rely on the doctor for that while I focused on healthy eating, remaining active, and keeping my doctor and lab schedules.
I was referred to a Gastroenterologist (GI) who diagnosed my disease early in its development. He followed me for almost 8 years before my MELD score qualified me to be referred to the Liver Transplant Center, where I was evaluated and placed on the UNOS transplant waiting list. That is when my MELD score became a part of the medical vocabulary. In all honesty, I don't know the answer to your inquiry about the sodium, but I am aware that aware that lab levels and MELD score can go up and down over time. Doctors look at patterns-over-time.
The MELD Score (Model for End Stage Liver Disease) is based on specific blood lab results that a transplant team uses to evaluate how critically someone with advanced liver disease/cirrhosis needs a liver transplant.

Here is information from the Mayo Connect Transplant Blog:
-Liver Transplantation: Understanding the MELD Score
https://connect.mayoclinic.org/blog/transplant/newsfeed-post/liver-transplantation-understanding-the-meld-score/
.
@wvcaregiver, Has your husband been diagnosed with a particular liver condition? Is he being followed by a GI or liver specialist? When is your husband's next appointment? Why don't you present your questions to him/her?