Etiology and mechanisms of undernourishment in the cirrhotic patient

Gonzales H.V. · Anales de la Facultad de Medicina (2020) · DOI: 10.15381/anales.v81i2.18404

Resumen

The liver plays a role in the caloric homeostasis; it is involved in the digestive process, so it is not surprising to find malnutrition in cirrhosis, because they have an inability to meet their macro and micronutrient requirements. The pathogenesis of malnutrition is multifactorial and complex and frequently difficult to understand and includes reduced nutrient intake, decreased protein biosynthesis and increased loss, poor intestinal absorption, disturbances in the use of the substrate, abnormalities in the metabolism of carbohydrates, lipids and proteins and increased of pro-inflammatory cytokines resulting in a hypermetabolic state as well as increase in protein-energy expenditure and requirements. The evaluation of nutritional status is transcendental for a clinical-therapeutic approach, due to its influence on the prognosis and response to liver transplantation. Despite the evidence on the prevalence of malnutrition in liver cirrhosis, this condition remains poorly recognized, poorly diagnosed and poorly treated. It is controversial, if malnutrition can be reversed in cirrhotic; there is an agreement about the need to improve the food intake, avoiding limitations and restrictions that are not based on evidence. © Universidad Nacional Mayor de San Marcos, Facultad de Medicina.

Instituciones: Universidad Nacional Mayor de San Marcos