Nutrition Assessment and Management in Patients with Cirrhosis and Cognitive Impairment: A Comprehensive Review of Literature
Hepatic encephalopathy (HE) represents a common complication of liver cirrhosis. Protein-calorie malnutrition is frequently encountered in the cirrhotic patient and its most obvious clinical manifestation is sarcopenia. This condition represents a risk factor for HE occurrence because skeletal muscl...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/10/2842 |
| _version_ | 1797498890208935936 |
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| author | Jessica Faccioli Silvia Nardelli Stefania Gioia Oliviero Riggio Lorenzo Ridola |
| author_facet | Jessica Faccioli Silvia Nardelli Stefania Gioia Oliviero Riggio Lorenzo Ridola |
| author_sort | Jessica Faccioli |
| collection | DOAJ |
| description | Hepatic encephalopathy (HE) represents a common complication of liver cirrhosis. Protein-calorie malnutrition is frequently encountered in the cirrhotic patient and its most obvious clinical manifestation is sarcopenia. This condition represents a risk factor for HE occurrence because skeletal muscle acts as an alternative site for ammonium detoxification. Preventive intervention through an adequate assessment of nutritional status should be carried out at early stages of the disease and in a multidisciplinary team using both non-instrumental methods (food diary, anthropometric measurements, blood chemistry tests) and instrumental methods (bioimpedance testing, DEXA, CT, indirect calorimetry, dynamometry). Dietary recommendations for patients with HE do not differ from those for cirrhotic patient without HE. Daily caloric intake in the non-obese patient should be 30–40 Kcal/Kg/day with a protein intake of 1–1.5 g/Kg/day, especially of vegetable origin, through 4–6 meals daily. In patients with HE, it is also essential to monitor electrolyte balance, supplementing any micronutrient deficiencies such as sodium and zinc, as well as vitamin deficiencies because they can cause neurological symptoms similar to those of HE. In light of the critical role of nutritional status, this aspect should not be underestimated and should be included in the diagnostic–therapeutic algorithm of patients with HE. |
| first_indexed | 2024-03-10T03:39:43Z |
| format | Article |
| id | doaj.art-895b0adaac534409ae3a558767065636 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T03:39:43Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-895b0adaac534409ae3a5587670656362023-11-23T11:35:41ZengMDPI AGJournal of Clinical Medicine2077-03832022-05-011110284210.3390/jcm11102842Nutrition Assessment and Management in Patients with Cirrhosis and Cognitive Impairment: A Comprehensive Review of LiteratureJessica Faccioli0Silvia Nardelli1Stefania Gioia2Oliviero Riggio3Lorenzo Ridola4Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, ItalyHepatic encephalopathy (HE) represents a common complication of liver cirrhosis. Protein-calorie malnutrition is frequently encountered in the cirrhotic patient and its most obvious clinical manifestation is sarcopenia. This condition represents a risk factor for HE occurrence because skeletal muscle acts as an alternative site for ammonium detoxification. Preventive intervention through an adequate assessment of nutritional status should be carried out at early stages of the disease and in a multidisciplinary team using both non-instrumental methods (food diary, anthropometric measurements, blood chemistry tests) and instrumental methods (bioimpedance testing, DEXA, CT, indirect calorimetry, dynamometry). Dietary recommendations for patients with HE do not differ from those for cirrhotic patient without HE. Daily caloric intake in the non-obese patient should be 30–40 Kcal/Kg/day with a protein intake of 1–1.5 g/Kg/day, especially of vegetable origin, through 4–6 meals daily. In patients with HE, it is also essential to monitor electrolyte balance, supplementing any micronutrient deficiencies such as sodium and zinc, as well as vitamin deficiencies because they can cause neurological symptoms similar to those of HE. In light of the critical role of nutritional status, this aspect should not be underestimated and should be included in the diagnostic–therapeutic algorithm of patients with HE.https://www.mdpi.com/2077-0383/11/10/2842hepatic encephalopathyprotein caloric-malnutritionsarcopeniadietary interventioncirrhosismortality |
| spellingShingle | Jessica Faccioli Silvia Nardelli Stefania Gioia Oliviero Riggio Lorenzo Ridola Nutrition Assessment and Management in Patients with Cirrhosis and Cognitive Impairment: A Comprehensive Review of Literature Journal of Clinical Medicine hepatic encephalopathy protein caloric-malnutrition sarcopenia dietary intervention cirrhosis mortality |
| title | Nutrition Assessment and Management in Patients with Cirrhosis and Cognitive Impairment: A Comprehensive Review of Literature |
| title_full | Nutrition Assessment and Management in Patients with Cirrhosis and Cognitive Impairment: A Comprehensive Review of Literature |
| title_fullStr | Nutrition Assessment and Management in Patients with Cirrhosis and Cognitive Impairment: A Comprehensive Review of Literature |
| title_full_unstemmed | Nutrition Assessment and Management in Patients with Cirrhosis and Cognitive Impairment: A Comprehensive Review of Literature |
| title_short | Nutrition Assessment and Management in Patients with Cirrhosis and Cognitive Impairment: A Comprehensive Review of Literature |
| title_sort | nutrition assessment and management in patients with cirrhosis and cognitive impairment a comprehensive review of literature |
| topic | hepatic encephalopathy protein caloric-malnutrition sarcopenia dietary intervention cirrhosis mortality |
| url | https://www.mdpi.com/2077-0383/11/10/2842 |
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