Nutritional Support in Chronic Liver Disease

Anne S Henkel; Alan L Buchman

Disclosures

Nat Clin Pract Gastroenterol Hepatol. 2006;3(4):202-209. 

In This Article

Summary and Introduction

Summary

Malnutrition is highly prevalent among patients with chronic liver disease and is nearly universal among patients awaiting liver transplantation. Malnutrition in patients with cirrhosis leads to increased morbidity and mortality rates. Furthermore, patients who are severely malnourished before transplant surgery have a higher rate of complications and a decreased overall survival rate after liver transplantation. In light of the high incidence of malnutrition among patients with chronic liver disease and the complications that result from malnutrition in these patients, it is essential to assess the nutritional status of all patients with liver disease, and to initiate treatment as indicated. This review addresses the etiologies of malnutrition, methods used to assess nutritional status, and appropriate treatment strategies.

Introduction

Malnutrition is an increasingly recognized complication of chronic liver disease that has important prognostic implications. Malnourished patients with cirrhosis have a higher rate of complications and, overall, an increased mortality rate.[1,2] Malnutrition has significant implications for liver transplantation; it has been shown that patients with poor nutritional status before transplantation have increased complications and higher mortality rates postoperatively.[3,4,5,6] Screening all patients with chronic liver disease for nutritional abnormalities can identify those at risk of developing preventable complications.[7] The initiation of nutritional therapy has the potential to reduce the risk of such complications, and to improve the overall mortality rate.

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