Nutritional assessment in cirrhosis

Abstract

Malnutrition is common in cirrhosis. It is associated with mortality and morbidity. Pathogenesis of malnutrition in cirrhotic patients is multifactorial. Nutritional assessment is crucial but often ignored. No gold standard of nutritional assessment tools is established. Many assessment tools have limitations for using in cirrhosis with fluid retention. CT scan to assess sarcopenia is promising. Royal Free Hospital-nutritional prioritizing tool (RFH-NPT) and Liver disease undernutrition screening tool (LDUST) are proposed as screening tools. Complete nutritional assessment should be performed in high risk patients. Vitamin and trace element levels should be checked. Adequate energy (at least 35 kcal/kg body weight) and protein (1.2 to 1.5 g/kg body weight) are recommended. Repeat assessment is advocated. In this review, pathogenesis, nutritional assessment tools and treatment of malnutrition in cirrhotic patients are presented. © JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND| 2019.