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      A practical approach to nutritional screening and assessment in cirrhosis.

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          Abstract

          Malnutrition is one of the most common complications of cirrhosis, associated with an increased risk of morbidity and mortality. As a potentially modifiable condition, it is of particular importance to identify malnourished patients so that nutritional therapy can be instituted. Nutrition screening and assessment are infrequently performed in patients with cirrhosis. The reasons for this are multifactorial, including the absence of a validated "rapid" screening tool, multiple definitions of what constitutes malnutrition, and challenges with interpreting body composition and laboratory results in the setting of volume overload and liver dysfunction. This article summarizes the clinically relevant evidence and presents key issues, tools, and clinical options that are applicable to patients with cirrhosis. The definition, etiology, and clinically relevant outcomes associated with malnutrition are reviewed. Rapid nutritional screening is differentiated from more detailed nutritional assessment. Nutritional assessment in special populations, including women and the obese, and the role of inflammation are discussed. Multicenter studies using a common nutritional screening/assessment strategy are the next steps to fast-track adoption and implementation of nutrition-related evaluations into routine clinical practice. (Hepatology 2017;65:1044-1057).

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          Author and article information

          Journal
          Hepatology
          Hepatology (Baltimore, Md.)
          Wiley-Blackwell
          1527-3350
          0270-9139
          Mar 2017
          : 65
          : 3
          Affiliations
          [1 ] Cirrhosis Care Clinic and CEGIIR, University of Alberta, Edmonton, AB, Canada.
          [2 ] Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada.
          [3 ] Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
          [4 ] Gastroenterology, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
          Article
          10.1002/hep.29003
          28027577
          b4aae117-710f-4d38-881a-4f2db334b426
          History

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