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Nutrition in the management of cirrhosis and its neurological complications.

Abstract

Malnutrition is a common feature of chronic liver diseases that is often associated with a poor prognosis including worsening of clinical outcome, neuropsychiatric complications as well as outcome following liver transplantation. Nutritional assessment in patients with cirrhosis is challenging owing to confounding factors related to liver failure. The objectives of nutritional intervention in cirrhotic patients are the support of liver regeneration, the prevention or correction of specific nutritional deficiencies and the prevention and/or treatment of the complications of liver disease per se and of liver transplantation. Nutritional recommendations target the optimal supply of adequate substrates related to requirements linked to energy, protein, carbohydrates, lipids, vitamins and minerals. Some issues relating to malnutrition in chronic liver disease remain to be addressed including the development of an appropriate well-validated nutritional assessment tool, the identification of mechanistic targets or therapy for sarcopenia, the development of nutritional recommendations for obese cirrhotic patients and liver-transplant recipients and the elucidation of the roles of vitamin A hepatotoxicity, as well as the impact of deficiencies in riboflavin and zinc on clinical outcomes. Early identification and treatment of malnutrition in chronic liver disease has the potential to lead to better disease outcome as well as prevention of the complications of chronic liver disease and improved transplant outcomes.

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  • Authors+Show Affiliations

    ,

    Département de nutrition, Faculté de médecine, Université de Montréal, Montréal, Canada ; Unité de recherche en sciences neurologiques, Hôpital Saint-Luc (CHUM), Université de Montréal, Montréal, Canada.

    Unité de recherche en sciences neurologiques, Hôpital Saint-Luc (CHUM), Université de Montréal, Montréal, Canada.

    Source

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    25755550

    Citation

    Bémeur, Chantal, and Roger F. Butterworth. "Nutrition in the Management of Cirrhosis and Its Neurological Complications." Journal of Clinical and Experimental Hepatology, vol. 4, no. 2, 2014, pp. 141-50.
    Bémeur C, Butterworth RF. Nutrition in the management of cirrhosis and its neurological complications. J Clin Exp Hepatol. 2014;4(2):141-50.
    Bémeur, C., & Butterworth, R. F. (2014). Nutrition in the management of cirrhosis and its neurological complications. Journal of Clinical and Experimental Hepatology, 4(2), pp. 141-50. doi:10.1016/j.jceh.2013.05.008.
    Bémeur C, Butterworth RF. Nutrition in the Management of Cirrhosis and Its Neurological Complications. J Clin Exp Hepatol. 2014;4(2):141-50. PubMed PMID: 25755550.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Nutrition in the management of cirrhosis and its neurological complications. AU - Bémeur,Chantal, AU - Butterworth,Roger F, Y1 - 2013/06/11/ PY - 2013/03/12/received PY - 2013/05/19/accepted PY - 2015/3/11/entrez PY - 2015/3/11/pubmed PY - 2015/3/11/medline KW - AAAs, aromatic amino acids KW - BCAAs, branched-chain amino acids KW - BMI, body mass index KW - CNS, central nervous system KW - CONUT, controlling nutritional status KW - HE, hepatic encephalopathy KW - ISHEN, International Society for Hepatic Encephalopathy and Nitrogen metabolism KW - NAFLD, non-alcoholic fatty liver disease KW - NASH, non-alcoholic steato-hepatitis KW - PNI, prognostic nutritional index KW - complications KW - hepatic encephalopathy KW - liver disease KW - liver transplantation KW - nutritional status SP - 141 EP - 50 JF - Journal of clinical and experimental hepatology JO - J Clin Exp Hepatol VL - 4 IS - 2 N2 - Malnutrition is a common feature of chronic liver diseases that is often associated with a poor prognosis including worsening of clinical outcome, neuropsychiatric complications as well as outcome following liver transplantation. Nutritional assessment in patients with cirrhosis is challenging owing to confounding factors related to liver failure. The objectives of nutritional intervention in cirrhotic patients are the support of liver regeneration, the prevention or correction of specific nutritional deficiencies and the prevention and/or treatment of the complications of liver disease per se and of liver transplantation. Nutritional recommendations target the optimal supply of adequate substrates related to requirements linked to energy, protein, carbohydrates, lipids, vitamins and minerals. Some issues relating to malnutrition in chronic liver disease remain to be addressed including the development of an appropriate well-validated nutritional assessment tool, the identification of mechanistic targets or therapy for sarcopenia, the development of nutritional recommendations for obese cirrhotic patients and liver-transplant recipients and the elucidation of the roles of vitamin A hepatotoxicity, as well as the impact of deficiencies in riboflavin and zinc on clinical outcomes. Early identification and treatment of malnutrition in chronic liver disease has the potential to lead to better disease outcome as well as prevention of the complications of chronic liver disease and improved transplant outcomes. SN - 0973-6883 UR - https://www.unboundmedicine.com/medline/citation/25755550/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0973-6883(13)00555-0 DB - PRIME DP - Unbound Medicine ER -