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Bémeur C, Butterworth RF. Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications. J Clin Exp Hepatol. 2015;5:S131-40doi: 10.1016/j.jceh.2015.02.004.
Bémeur, C., & Butterworth, R. F. (2015). Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications. Journal of clinical and experimental hepatology, 5S131-40. https://doi.org/10.1016/j.jceh.2015.02.004
Bémeur, Chantal, and Butterworth, Roger F. "Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications." Journal of clinical and experimental hepatology vol. 5 (2015): S131-40. doi: https://doi.org/10.1016/j.jceh.2015.02.004
Bémeur C, Butterworth RF. Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications. J Clin Exp Hepatol. 2015 Mar;5:S131-40. doi: 10.1016/j.jceh.2015.02.004. Epub 2015 Feb 19. PMID: 26041952; PMCID: PMC4442848.
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J Clin Exp Hepatol. 2015 Mar;5:S131-40. doi: 10.1016/j.jceh.2015.02.004. Epub 2015 Feb 19.

Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications.

Journal of clinical and experimental hepatology

Chantal Bémeur, Roger F Butterworth

Affiliations

  1. 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.
  2. Unité de recherche en sciences neurologiques, Hôpital Saint-Luc (CHUM), Université de Montréal, Montréal, Canada.

PMID: 26041952 PMCID: PMC4442848 DOI: 10.1016/j.jceh.2015.02.004

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.

Keywords: AAAs, aromatic amino acids; BCAAs, branched-chain amino acids; BMI, body mass index; CNS, central nervous system; CONUT, controlling nutritional status; HE, hepatic encephalopathy; ISHEN, International Society for Hepatic Encephalopathy and Nitrogen metabolism; NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steato-hepatitis; PNI, prognostic nutritional index; complications; hepatic encephalopathy; liver disease; liver transplantation; nutritional status

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