FREQUENCY OF HYPOCALCEMIA IN PATIENTS WITH CHRONIC LIVER DISEASE

Background: Chronic liver disease is characterized by persistent hepatic inflammation, fibrosis, and architectural distortion, leading to progressive hepatic dysfunction. The impairment of liver function disrupts multiple metabolic pathways, including vitamin D metabolism, which plays a crucial role in calcium homeostasis. Electrolyte imbalances, particularly hypocalcemia, are common but often overlooked in patients with chronic liver disease. Despite its clinical significance, limited data exist on the burden of calcium deficiency in this population, particularly in local settings. This study aimed to assess the prevalence of asymptomatic hypocalcemia in patients with chronic liver disease and its association with demographic and disease-related factors. Objective: To determine the frequency of hypocalcemia and its association with gender, age, and severity of liver disease in patients with chronic liver disease. Methods: This cross-sectional study was conducted at the Department of Gastroenterology, Hayatabad Medical Complex, Peshawar, from June 1, 2024, to November 30, 2024. A total of 159 male and female patients aged 20 to 70 years, diagnosed with chronic liver disease on ultrasound, were enrolled. Hypocalcemia was defined as a serum calcium level below 8.5 mg/dL. Relevant demographic, clinical, and biochemical data were recorded. Data analysis was performed using SPSS version 25, and statistical significance was set at p ≤ 0.05. Results: The mean age of participants was 54.12 ± 7.189 years, with 144 (90.6%) patients older than 45 years. Males constituted 111 (69.8%) of the sample. A BMI greater than 24.0 kg/m² was recorded in 85 (53.5%) patients. The mean duration of chronic liver disease was 14.57 ± 7.533 years, with 103 (64.8%) patients having the disease for more than 10 years. Cirrhosis severity assessment showed that 61 (38.4%) patients had Child-Pugh Class C cirrhosis. Hypocalcemia was detected in 110 (69.2%) patients, with a significantly higher prevalence in females (89.6%) compared to males (60.4%) (p < 0.001). Advanced cirrhosis was strongly associated with hypocalcemia, as 52 (85.2%) patients in Child-Pugh Class C had low calcium levels (p = 0.001). Conclusion: Hypocalcemia is highly prevalent in patients with chronic liver disease, particularly among females and those with advanced cirrhosis. The findings underscore the importance of routine calcium monitoring and early intervention in this vulnerable population.