NPPA and Cirrhosis: The causes of hyponatremia in cirrhosis include obvious liver damage, Na+-K+-ATP dysfunction, and reduced cellular release of Na+; aldosterone, antidiuretic hormone, atrial natriuretic peptide, and other hormones not being metabolized by the liver, resulting in water retention and dilution causing low sodium levels; and the rapid release of large amounts of AC, excessive diuresis, vomiting, diarrhea, and long-term low-salt diets, causing sodium loss (37).