Influence of the metabolic complications of liver cirrhosis on dietary intake.

The role of the nutrition is discussed in relation to chronic liver disease. An outline of the general principles involved in regulating nutrition in patients with advanced liver disease is given followed by an evaluation of the effects of malnutrition on the outcome of the disease. Major problems faced over the course of advanced liver disease are carbohydrate intolerance, sodium and fluid retention which may progress to hepatorenal syndrome, and hepatic encephalopathy. Interest on diet regulation in such cases has been recently reemphasized in multicenter studies particularly in the liver transplant setting and alcoholic liver disease. Controversies exist regarding albumin infusion after paracenthesis, low protein diet in hepatic encephalopathy and water restriction before sodium. The effect of nutrition on the outcome of liver disease and survival is not well established. However patients with better nutritional state do much better after transplant.