Nutritional Support in Chronic Liver Disease

Anne S Henkel; Alan L Buchman


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

In This Article


Protein-calorie malnutrition (PCM)—a condition of body wasting related to dietary deficiency of calories and protein—is found in 65-90% of patients with advanced liver disease and in almost 100% of candidates for liver transplantation.[8,9] Patients with chronic liver disease also frequently develop micronutrient deficiencies, which can have a more insidious presentation than the overt cachexia seen in patients with PCM. There is a direct correlation between the progression of the liver disease and the severity of malnutrition.[10,11] Malnutrition develops in patients with cirrhosis irrespective of the etiology of their disease[12] and occurs with roughly equal incidence in patients with alcoholic and nonalcoholic liver disease.[13] Patients with cholestatic liver disease are subject to calorie depletion, whereas patients with noncholestatic disease predominantly experience protein depletion.[14] Additionally, cholestatic disease is more frequently associated with a deficiency in fat-soluble vitamins than noncholestatic disease.[15] Malnutrition is not typically a complication of acute liver injury, but manifests with progression to liver failure.


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