Importance of malnutrition in patients with cirrhosis

Gokturk, Huseyin Savas; Şelçuk, Haldun

doi:10.5152/tjg.2015.0224

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…The various conventional parameters, such as BMI, MAC and TSF, reflect malnutrition and the severity of liver disease to a certain extent (37) , but they are insufficient for the evaluation of the risk of malnutrition (3,25,38) . BMI has been found to be inaccurate in patients with ascites (39,40) .…”

Section: Discussionmentioning

confidence: 99%

Royal Free Hospital-Nutritional Prioritizing Tool improves the prediction of malnutrition risk outcomes in liver cirrhosis patients compared with Nutritional Risk Screening 2002

Zhu

Feng

et al. 2020

Br J Nutr

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The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines recommend Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) to identify malnutrition risk in patients with liver disease. However, little is known about the application of RFH-NPT to screen for the risk of malnutrition in China, where patients primarily suffer from hepatitis virus-related cirrhosis. A total of 155 cirrhosis patients without liver cancer or uncontrolled comorbid illness were enrolled in this prospective study. We administered the Nutritional Risk Screening 2002 (NRS-2002), RFH-NPT, Malnutrition Universal Screening Tool(MUST), and Liver Disease Undernutrition Screening Tool (LDUST) to the patients within 24 h after admission and performed follow-up observations for 1.5 years. The RFH-NPT and NRS-2002 had higher sensitivities (64.8% and 52.4%) and specificities (60% and 70%) than the other tools with regard to screening for the malnutrition risk in cirrhotic patients. The prevalence of nutritional risk was higher under the use of RFH-NPT against the NRS-2002(63% vs. 51%). RFH-NPT tended more easily to detect the malnutrition risk in patients with advanced Child-Pugh classes (B and C) and lower MELD scores (<15) compared with NRS-2002. The RFH-NPT score was an independent predictive factor for mortality. Patients identified as being at high malnutrition risk with the RFH-NPT had a higher mortality rate than those at a low risk; the same result was not obtained with the NRS-2002. Therefore, we suggest that using RFH-NPT improves the ability of clinicians to predict malnutrition risk in patients with cirrhosis primarily caused by hepatitis virus infection at an earlier stage.

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Section: Discussionmentioning

confidence: 99%

Royal Free Hospital-Nutritional Prioritizing Tool improves the prediction of malnutrition risk outcomes in liver cirrhosis patients compared with Nutritional Risk Screening 2002

Zhu

Feng

et al. 2020

Br J Nutr

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“…12 Persyaratan diet pada penyakit gangguan hati menurut European Society for Clinical Nutrition and Metabolism (ESPEN) adalah diberikan energi 35-40 kkal/kgBB/hari, protein 1-1,5 g/kgBB/hari tanpa ensefalopati hepatikum atau 0,6-0,8 g/kgBB/hari dengan ensefalopati hepatikum, karbohidrat 45-65%, dan lemak 25-30%. 5,13,14 Protein diutamakan dari protein nabati dan produk susu karena lebih mudah ditoleransi serta rendah Aromatic Amino Acids (AAA) dan amonia daripada protein ikan dan daging. Protein nabati mengandung serat yang dapat mempercepat pengeluaran amonia melalui feses dan mengandung Branched-Chain Amino Acids (BCAA) tinggi.…”

Section: Pendahuluanunclassified

Pengembangan formula enteral hepatogomax untuk penyakit hati berbasis tepung kedelai dan tepung susu kambing

Rahmadanti

Candra

Nissa

2020

JGI

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Background: Patients with chronic liver disease were risk to be malnourished due to malabsorption, hipermetabolic condition, and not receiving adequate nutrients orally. Diet therapy through enteral feeding based on soybean flour and goat milk flour play role as an alternative formula for chronic liver patients since it contains high Branched-Chain Amino Acids (BCAA) and Medium-chain Triglyceride (MCT).Objectives: to analyze viscosity, nutrient content, protein digestibility, and organoleptic properties of enteral feeding using soybean flour and goat milk flour.Methods: An experimental study using 3 distinc formula with ratio soybean flour to goat milk flour was P1(45:55), P2(50:50), P3(55: 45). Viscosity, fat, carbohydrate content, and energy density were analyzed using One Way Anova followed by Tukey test while protein content, protein digestibility, and energy density were analyzed using Kruskal Wallis followed by Mann Whitney test. Organoleptic properties were analyzed using Friedman followed by Wilcoxon test.Results:The higher the soybean flour, the higher the formula viscosity (p=0.000) and protein (0.007). In contrast, the higher the got milk flour, the higher the fat (p=0.000), carbohydrate (p=0.000), energy (p=0.000) and energy density (p=0.013). Formula P3 has the highest viscosity (1.93±0.039 cP) and protein (9.66±0.16%), while P1 has the highest fat (27.33±0.15%), carbohydrate (65.97±0.23%), energy (1.175±3.04 kkal), energy density (1.17±0.00 kkal/ml), and protein digestibility (45.90±1.49%) among others. However, there is no effect of different formula toward protein digestibility (p=0.116). Organoleptic properties showed that the higher the got milk flour, the higher its acceptance in all aspect including color (p=0.046), flavor (p=0.000), taste (p=0.009) dan texture (p=0.002).Conclusion: P1 was the best formula due to its level of viscosity, fat, energy, protein and energy density that meet requirements according to European Society for Clinical Nutrition and Metabolism (ESPEN). P1 also has the highest protein digestibility, and have the highest score of all organoleptic parameters.

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“…Inadequate dietary intake in cirrhosis patients is also linked with the altered taste, possibly due to certain medications and anorexia. Other factors for decreased oral intake include hepatic encephalopathy, ascites, abdominal distention, dietary restrictions and starvation for various tests and procedures (4) .…”

Section: Evaluating the Impact Of Early Nutritional Assessment And In...mentioning

confidence: 99%

Evaluating the Impact of Early Nutritional Assessment and Intervention in Hospitalized Liver Cirrhosis Patients

Javaid

Khan

ALI

et al. 2022

Arq. Gastroenterol.

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Background Malnutrition is common in liver cirrhosis patients that is correlated with early complications, morbidity and mortality. Objective The purpose of the study was to assess nutritional status, impact of nutritional screening and intervention in liver cirrhosis patients by evaluating their actual energy and protein intake during hospital stay. Methods A cross sectional study was conducted wherein all patients’ nutritional status was defined by Subjective Global Assessment tool. Adequate energy and protein supply were planned and executed by using individualized nutritional plan for patients with dietitian’s collaboration. Anthropometric measurements included height, weight, body mass index, mid upper arm circumference, hand grip strength and triceps skin-fold thickness. Biochemical tests included haemoglobin, mean corpuscular haemoglobin, volume and concentration, albumin and liver function tests. To record the daily food intake, a 24-hour dietary recall was used. Results Overall 83 patients (mean age 55) were included, among them 46% of patients were moderately malnourished, 12% were normal, while 42% of cirrhotic patients were severely depleted according to Subjective Global Assessment. The mean intake of calories and protein was improved during stay in hospital after nutritional intervention and critical monitoring (P<0.05). Anthropometric measurements at baseline and discharge showed significant differences (P <0.05) in weight, body mass index, triceps skin fold thickness and mid upper arm circumference values, but not in hand grip strength that was associated with malnourishment among patients. Conclusion Providing individualized nutritional intervention and its monitoring by qualified dietitians during hospital stay helps to improve intake in patients that prevent further risk of malnutrition and related complications.

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Importance of malnutrition in patients with cirrhosis

Cited by 8 publications

References 20 publications

Royal Free Hospital-Nutritional Prioritizing Tool improves the prediction of malnutrition risk outcomes in liver cirrhosis patients compared with Nutritional Risk Screening 2002

Royal Free Hospital-Nutritional Prioritizing Tool improves the prediction of malnutrition risk outcomes in liver cirrhosis patients compared with Nutritional Risk Screening 2002

Pengembangan formula enteral hepatogomax untuk penyakit hati berbasis tepung kedelai dan tepung susu kambing

Evaluating the Impact of Early Nutritional Assessment and Intervention in Hospitalized Liver Cirrhosis Patients

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