Nutritional disorders in chronic liver diseases. Part 1. Diagnostic methods of nutritional disorders

Abstract

Introduction. Malnutrition is a clinically significant condition and a predictor of poor outcomes in liver diseases. The first step towards minimizing poor outcomes is the alertness of clinicians regarding changes in nutritional status, the use of appropriate diagnostic methods that determine the volume and complex of preventive measures. Objectives. To review in brief publications covering the problem of diagnosing malnutrition in chronic diffuse liver diseases. Material and methods. The study and analysis of articles in English and Russian with a search depth of up to 30 years, contained in the PubMed, Cochrane Collaboration, UpToDate, eLIBRARY databases, were carried out. Key words and their combinations were: “body mass index”, “malnutrition”, “muscle wasting”, “nutrition risk”, “sarcopenia”, “nutrition status”, “complications of liver cirrhosis”. Results. Recent data about changes in nutritional status, problems of diagnosing malnutrition and detecting nutritional risk in liver diseases have been considered. The most common and effective methods for assessing malnutrition are described both at the stage of primary diagnosis and during the dynamic monitoring of patients with chronic liver diseases. Conclusions. Malnutrition and sarcopenia are associated with a poor prognosis with regard to severe, often fatal complications – hepatic encephalopathy, bacterial infections. The clinician must dynamically observe changes in nutritional status and apply available tools to identify the risk of malnutrition in patients with chronic liver diseases, based on the latest practical guidelines.

Keywords

• liver cirrhosis
• malnutrition
• sarcopenia
• nutritional status