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Malnutrition in Patients with Liver Cirrhosis

Liver cirrhosis is an increasing public health threat worldwide. Malnutrition is a serious complication of cirrhosis and is associated with worse outcomes. With this review, we aim to describe the prevalence of malnutrition, pathophysiological mechanisms, diagnostic tools and therapeutic targets to...

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Autores principales: Traub, Julia, Reiss, Lisa, Aliwa, Benard, Stadlbauer, Vanessa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915767/
https://www.ncbi.nlm.nih.gov/pubmed/33562292
http://dx.doi.org/10.3390/nu13020540
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author Traub, Julia
Reiss, Lisa
Aliwa, Benard
Stadlbauer, Vanessa
author_facet Traub, Julia
Reiss, Lisa
Aliwa, Benard
Stadlbauer, Vanessa
author_sort Traub, Julia
collection PubMed
description Liver cirrhosis is an increasing public health threat worldwide. Malnutrition is a serious complication of cirrhosis and is associated with worse outcomes. With this review, we aim to describe the prevalence of malnutrition, pathophysiological mechanisms, diagnostic tools and therapeutic targets to treat malnutrition. Malnutrition is frequently underdiagnosed and occurs—depending on the screening methods used and patient populations studied—in 5–92% of patients. Decreased energy and protein intake, inflammation, malabsorption, altered nutrient metabolism, hypermetabolism, hormonal disturbances and gut microbiome dysbiosis can contribute to malnutrition. The stepwise diagnostic approach includes a rapid prescreen, the use of a specific screening tool, such as the Royal Free Hospital Nutritional Prioritizing Tool and a nutritional assessment by dieticians. General dietary measures—especially the timing of meals—oral nutritional supplements, micronutrient supplementation and the role of amino acids are discussed. In summary malnutrition in cirrhosis is common and needs more attention by health care professionals involved in the care of patients with cirrhosis. Screening and assessment for malnutrition should be carried out regularly in cirrhotic patients, ideally by a multidisciplinary team. Further research is needed to better clarify pathogenic mechanisms such as the role of the gut-liver-axis and to develop targeted therapeutic strategies.
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spelling pubmed-79157672021-03-01 Malnutrition in Patients with Liver Cirrhosis Traub, Julia Reiss, Lisa Aliwa, Benard Stadlbauer, Vanessa Nutrients Review Liver cirrhosis is an increasing public health threat worldwide. Malnutrition is a serious complication of cirrhosis and is associated with worse outcomes. With this review, we aim to describe the prevalence of malnutrition, pathophysiological mechanisms, diagnostic tools and therapeutic targets to treat malnutrition. Malnutrition is frequently underdiagnosed and occurs—depending on the screening methods used and patient populations studied—in 5–92% of patients. Decreased energy and protein intake, inflammation, malabsorption, altered nutrient metabolism, hypermetabolism, hormonal disturbances and gut microbiome dysbiosis can contribute to malnutrition. The stepwise diagnostic approach includes a rapid prescreen, the use of a specific screening tool, such as the Royal Free Hospital Nutritional Prioritizing Tool and a nutritional assessment by dieticians. General dietary measures—especially the timing of meals—oral nutritional supplements, micronutrient supplementation and the role of amino acids are discussed. In summary malnutrition in cirrhosis is common and needs more attention by health care professionals involved in the care of patients with cirrhosis. Screening and assessment for malnutrition should be carried out regularly in cirrhotic patients, ideally by a multidisciplinary team. Further research is needed to better clarify pathogenic mechanisms such as the role of the gut-liver-axis and to develop targeted therapeutic strategies. MDPI 2021-02-07 /pmc/articles/PMC7915767/ /pubmed/33562292 http://dx.doi.org/10.3390/nu13020540 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Traub, Julia
Reiss, Lisa
Aliwa, Benard
Stadlbauer, Vanessa
Malnutrition in Patients with Liver Cirrhosis
title Malnutrition in Patients with Liver Cirrhosis
title_full Malnutrition in Patients with Liver Cirrhosis
title_fullStr Malnutrition in Patients with Liver Cirrhosis
title_full_unstemmed Malnutrition in Patients with Liver Cirrhosis
title_short Malnutrition in Patients with Liver Cirrhosis
title_sort malnutrition in patients with liver cirrhosis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915767/
https://www.ncbi.nlm.nih.gov/pubmed/33562292
http://dx.doi.org/10.3390/nu13020540
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