-Context -Malnutrition in cirrhotic patients with end-stage disease is common, and the degree of nutritional debilitation can play an important role in the pathogenesis of complications and cause a negative impact on prognosis. However, it involves difficulties and controversies regarding the identification of the best nutritional assessment method. Objective -To identify a method that provides a safe and effective nutritional diagnosis. Methods -Cross-sectional study with 129 cirrhotic patients. Anthropometric measurements, subjective global assessment, hand grip strength and bioelectrical impedance. Results -Through phase angle of bioelectrical impedance analysis (BIA) method, significant associations with Child-Pugh (P = 0.008), age group and gender were observed. The ROC (receiver operator characteristic) curve was generated to determine the best cutoff point of the phase angle of cirrhotic patients, serving as one of the reference parameters for the nutritional assessment with bioimpedance in this study, considering the classification through Child-Pugh score as the reference standard for the clinical conditions of patients with cirrhosis. Conclusions -The assessment through bioelectrical impedance presented a statistically significant correlation with Child-Pugh score. The identification of phase angle of 5.44º is the new parameter suggested for the classification of the nutritional conditions of cirrhotic patients.

-Background -Patients with liver disease often present protein-energy malnutrition. The assessment of food intake is very important in the investigation regarding the "health-disease" process. Objective -To assess dietary intake of cirrhotic patients through food record during 3 days, correlating it with the nutritional status of the patient and the stage of the disease. Methods -Cirrhotic outpatients from the Santa Casa de Misericórdia Hospital, RS, Brazil, were assessed. Nutritional assessment was performed by anthropometry; non-dominating handgrip strength; adductor pollicis muscle thickness; phase angle by bioelectrical impedance analysis; and Subjective Global Assessment. For analysis of food consumption we used the food records of 3 days using scales for weighing of all foods. Results -We evaluated 25 (68%) patients, in which there was a prevalence of cirrhosis by hepatitis C virus. The upper arm circumference, handgrip strength and phase angle by bioelectrical impedance analysis diagnosed 56% of malnourished. Phase angle by bioelectrical impedance analysis and upper arm circumference were associated with Child-Pugh score (P<0.05). The average consumption of calories, carbohydrates, proteins and lipids were within the recommended. However, sodium was above the recommendations, 106±57.2 mEq, and was inversely associated with Child-Pugh score (rs=-0.410; P=0.042). Conclusion -Food intake did not have a significant difference between the Child-Pugh scores and nutritional status. In addition, food intake did not vary neither according to the stage of the disease, nor to the nutritional assessment, by the phase angle by bioelectrical impedance analysis.

Este trabajo fue recibido el 2 de Mayo de 2012 y aceptado para ser publicado el 28 de Octubre de 2012. seases has been the focus of several recent studies (4,14,17,18). Different methods may be used in the nutritional assessment in this patients, such as nutritional anamnesis, dietary intake analisys, subjective global assessment, anthropometry, biochemical and immunological methods, composite indexes, such as the global assessment proposed by the Royal Free Hospital, and functional tests, such as dynamometry (14,15,17). In fact, the definition of nutritional diagnosis, despite the various methods available in end-stage liver diseases is still controversial (19,20). Reduced dietary intake is frequent and one of the main causes of malnutrition in patients with liver diseases; therefore, the early detection of malnutrition is crucial to proper nutritional guidance to these patients. For this reason, studies on this area still necessary. OBJECTIVES The purpose of this study was to quantify the dietary intake and compare different nutritional assessment methods ABSTRACT Protein-calorie malnutrition (PCM) is a prognostic factor increasing complications and mortality in chronic liver diseases. Objectives: To quantify the dietary intake and compare different methods of nutritional assessment in patients with chronic liver diseases. Ninety seven outpatients of Hospital de Clínicas de Porto Alegre, with chronic hepatits (CH) and cirrhosis (CIR), were assessed from April 2009 to January 2010. The CH patients presented higher calorie and protein intake (p<0.05) than the CIR patients.

Introducción: la elección del método para la evaluación nutricional es fundamental para el correcto seguimiento del estado nutricional de los pacientes sometidos al trasplante de hígado.Objetivos: evaluar y comparar el estado nutricional de los pacientes antes y después del trasplante de hígado por el tiempo de un año para los diferentes métodos de evaluación nutricional.Métodos: se evaluaron los pacientes que se sometieron a un trasplante de hígado en diferentes momentos: pretrasplante, 1, 3, 6 y 12 meses después del procedimiento, en la Hermandad de la Santa Casa de Porto Alegre, Porto Alegre, RS, Brasil. Los métodos utilizados fueron la antropometría, la fuerza de apretón de manos por la fuerza de agarre no dominante (FAM), el espesor del músculo aductor del pulgar y el ángulo de fase (AF) por bioimpedancia eléctrica (BIA). En todas las evaluaciones se tomaron las mismas medidas.Resultados: las evaluaciones se llevaron a cabo en 22 pacientes. Los métodos que mostraron mayor prevalencia de pacientes desnutridos antes del trasplante fueron la FA por BIA (25%), la circunferencia muscular del brazo (CMB) (21,9%) y la circunferencia del brazo (CB) (18,8%). Al comparar el estado nutricional de los pacientes durante el seguimiento, hubo diferencia significativa en los métodos de evaluación de CB, espesor del pliegue cutáneo triciptal y AF por la BIA. Al final del seguimiento, los métodos de evaluación nutricional fueron nuevamente comparados y mostraron de diferencias significativas, siendo la FAM el método de mayor detección de desnutrición.Conclusiones: se sugiere que podría intensificarse el uso del método AF por la BIA en esta población, ya que los resultados están en consonancia con los encontrados en la literatura, siendo significativos, fiables y reproducibles.