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Nutritional therapy in cirrhosis
Author(s) -
MARCHESINI GIULIO,
MARZOCCHI REBECCA,
AGOSTINI FEDERICA,
BIANCHI GIAMPAOLO
Publication year - 2004
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2004.03712.x
Subject(s) - medicine , cirrhosis , malnutrition , medical nutrition therapy , catabolism , leucine , protein catabolism , encephalopathy , hepatic encephalopathy , randomized controlled trial , intensive care medicine , chronic liver disease , liver disease , amino acid , metabolism , biochemistry , biology
In recent years increasing interest has been given to nutritional therapy in a variety of chronic diseases, including cirrhosis. Protein/calorie malnutrition is a common feature of advanced liver disease, and considerably affects prognosis. Hence, the need for nutritional support to provide patients with the minimum protein requirements to balance increased catabolism. Although most patients tolerate normal protein supply, in subjects with impending encephalopathy a nutritional support with branched‐chain amino acids (BCAA) was suggested on the basis of neuro‐pharmacological studies. A large, randomized trial has recently provided evidence that BCAA may be superior to equicaloric and equinitrogenous supplements, improving survival and retarding hepatocellular failure. Administration schedules including a late evening supplementation may be particularly helpful. Biochemical studies are providing the rationale for the beneficial effects, showing that leucine may be an important regulator of amino acid/protein metabolism.