Ernährung bei Leberzirrhose

Gundling, Felix; Teich, Niels; Strebel, H; Schepp, Wolfgang; Pehl, C.

doi:10.1007/s00063-007-1056-x

Cited by 16 publications

(14 citation statements)

References 43 publications

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“…Vitamin A supplementation may be considered since vitamin A deficiency results in nyctalopia and dry cornea, and is associated with increased risk of hepatocellular carcinoma in patients with end-stage liver disease [117, 118]. Prescription of vitamin D, especially in patients with cholestasis (in combination with calcium since osteoporosis may be a complication of end-stage liver failure), is advised [118, 119]. Also, supplementation of vitamin K in conditions with high risk of bleeding such as the presence of impaired prothrombin time and oesophageal varices, should be considered [118].…”

Section: Water-soluble and Fat-soluble Vitaminsmentioning

confidence: 99%

“…Prescription of vitamin D, especially in patients with cholestasis (in combination with calcium since osteoporosis may be a complication of end-stage liver failure), is advised [118, 119]. Also, supplementation of vitamin K in conditions with high risk of bleeding such as the presence of impaired prothrombin time and oesophageal varices, should be considered [118]. In view of these findings, administration of multivitamin preparations is recommended.…”

Section: Water-soluble and Fat-soluble Vitaminsmentioning

confidence: 99%

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Role of Nutrition in the Management of Hepatic Encephalopathy in End-Stage Liver Failure

Bémeur

Desjardins

Butterworth

2010

Journal of Nutrition and Metabolism

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Malnutrition is common in patients with end-stage liver failure and hepatic encephalopathy, and is considered a significant prognostic factor affecting quality of life, outcome, and survival. The liver plays a crucial role in the regulation of nutrition by trafficking the metabolism of nutrients, their distribution and appropriate use by the body. Nutritional consequences with the potential to cause nervous system dysfunction occur in liver failure, and many factors contribute to malnutrition in hepatic failure. Among them are inadequate dietary intake, malabsorption, increased protein losses, hypermetabolism, insulin resistance, gastrointestinal bleeding, ascites, inflammation/infection, and hyponatremia. Patients at risk of malnutrition are relatively difficult to identify since liver disease may interfere with biomarkers of malnutrition. The supplementation of the diet with amino acids, antioxidants, vitamins as well as probiotics in addition to meeting energy and protein requirements may improve nutritional status, liver function, and hepatic encephalopathy in patients with end-stage liver failure.

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Section: Water-soluble and Fat-soluble Vitaminsmentioning

confidence: 99%

Section: Water-soluble and Fat-soluble Vitaminsmentioning

confidence: 99%

Role of Nutrition in the Management of Hepatic Encephalopathy in End-Stage Liver Failure

Bémeur

Desjardins

Butterworth

2010

Journal of Nutrition and Metabolism

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“…Malnutrition in patients with liver cirrhosis is quite complicated, and protein energy malnutrition is very common [14], thus nutritional support in patients with liver cirrhosis is very important. However, the choice and use of the nutrients should be considered carefully, otherwise there is a risk of increasing burden to liver [15].…”

Section: Discussionmentioning

confidence: 99%

Font Size: Compound Pollen Protein Nutrient Increases Serum Albumin in Cirrhotic Rats

et al. 2011

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BackgroundMalnutrition, especially protein-calorie malnutrition, is common in patients with liver cirrhosis. When in the status of malnutrition, the complications increase, liver function deteriorates, and the prognosis of patients with liver cirrhosis worsens. Hence, nutritional support and treatment is essential in patients with liver cirrhosis. Previous studies suggested that compound nutrition based on pollen can improve liver function, and can be a basic nutrient for patients with liver cirrhosis. However, the nutritional support based on pollen for malnutrition of cirrhotic patients needs to be further evaluated. In this study, we investigated the nutritional support of Noveliver, a new compound pollen protein nutrient, in the cirrhotic rats induced by carbon tetrachloride (CCl4).MethodsThe cirrhotic rats induced by CCl4 were treated with Noveliver in different doses, and treated with a regular compound pollen nutrient, untreated cirrhotic rats and normal rats were used as controls. Serum albumin were measured before and after the nutritional treatment in each group. At the same time, liver function, cytokines and pathological changes were also determined.ResultsIn the second week of nutritional treatment, the levels of serum albumin in normal control group, low dose noveliver group, high dose noveliver group, compound protein pollen group and spontaneous recovery group were 35.67 ± 1.42, 33.07 ± 1.27, 32.27 ± 1.50, 30.53 ± 0.25, 24.53 ± 3.56 (g/L), respectively, the differences among the groups were significant (F = 14.007, P = 0.000); The levels of serum albumin in low dose Noveliver group, high dose Noveliver group and the compound protein pollen group were higher than that in the spontaneous recovery group (P = 0.000, 0.001, 0.003, respectively). In the second week of nutritional treatment, the serum levels of HGF in normal control group, low dose Noveliver group, high dose Noveliver group, compound protein pollen group and spontaneous recovery group were 101.55 ± 0.87, 94.62 ± 8.80, 98.94 ± 3.68, 78.77 ± 21.79, 39.52 ± 14.03 (pg/ml), respectively, the differences among the groups were significant (F = 11.12, P = 0.002); the levels of HGF in low dose Noveliver group, high dose Noveliver group and the compound protein pollen group were higher than that in spontaneous recovery group (P = 0.001, 0.000, 0.005). Histological results showed that the fibrosis in spontaneous recovery group was severer than those in low dose Noveliver group, high dose Noveliver group and compound protein pollen group.ConclusionsOur data show that the both the Noveliver and the compound pollen protein nutrient increase the serum albumin and ameliorate malnutrition in cirrhotic rats; the recovery of serum albumin might be related to the hepatic damage repair and liver regeneration.

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“…One other important factor is the presence of impaired digestion and nutrient absorption due to portal hypertension, suggesting that controlling the pressure in the portal vein either by transjugular intrahepatic portocaval shunts (TIPS) or medication could improve the patients' nutritional status 10 . Cholestatic liver disease is another reason for impaired absorption, especially of fat‐soluble vitamins such as A,D,E and K, due to the reduced intraluminal bile salt concentrations 14,15 …”

Section: Causes Of Malnutrition In Liver Cirrhosismentioning

confidence: 99%

“…In the prescribed diets there should be no restriction on carbohydrate intake, 14 even in patients that suffer from diabetes mellitus or belong to the subgroup of patients with insulin resistance. This situation is not rare.…”

Section: Energy and Protein Requirementsmentioning

confidence: 99%

Malnutrition in end stage liver disease: Recommendations and nutritional support

Tsiaousi

Hatzitolios

Trygonis

et al. 2008

J of Gastro and Hepatol

128

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Malnutrition has increasingly been acknowledged as an important prognostic factor which can influence the clinical outcome of patients suffering from end-stage liver disease (ESLD). Despite the fact that malnutrition is not included in the Child-Pugh classification, its presence should alert clinicians to the same extent as do other complications, such as ascites and hepatic encephalopathy. The pathophysiological mechanisms and the clinical conditions that drive cirrhotic patients to an ill-balanced metabolic state are multiple and they intertwine. Inadequate offer of nutrients, the hypermetabolic state in cirrhosis, the diminished synthetic capacity of the liver and the impaired absorption of nutrients are the main reasons that disrupt the metabolic balance in ESLD. Identifying patients that are approaching the state of malnutrition by simple and easily applied methods is necessary in order to provide nutritional support to those that need it most. According to the European Society for Clinical Nutrition and Metabolism, simple bedside methods such as Subjective Global Assessment and anthropometric parameters are reliable in assessing the nutritional state of cirrhotic patients. Correcting the nutrient deficit of the affected patients is mandatory. Avoidance of alcohol and excess fat and ingestion of 4-6 meals/day containing carbohydrates and protein are the most common recommendations. In severe malnutrition, initiation of enteral feeding and/or use of special formulae such as branched-chain amino acid-enriched nutrient mixtures are often recommended. Enteral nutrition improves nutritional status and liver function, reduces complications, prolongs survival and is therefore indicated.

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Ernährung bei Leberzirrhose

Cited by 16 publications

References 43 publications

Role of Nutrition in the Management of Hepatic Encephalopathy in End-Stage Liver Failure

Role of Nutrition in the Management of Hepatic Encephalopathy in End-Stage Liver Failure

Font Size: Compound Pollen Protein Nutrient Increases Serum Albumin in Cirrhotic Rats

Malnutrition in end stage liver disease: Recommendations and nutritional support

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