Peter Jarčuška, Mária Zakuciová, Eduard Veseliny
Malnutrition is common diagnose in advanced liver dyfunction. Decreased food intake because of anorexia and vomitus, secondary malnutrition and increased nutritional requirement induced by alcohol consumption play important role in pathogenesis of malnutrition. Malnourished patients with advanced liver disease usally have insulin resistance and changes in metabolism of lipids and aminoacids. The most important methods for diagnose of malnutrition in liver disease are anthropometric tests. Nutritional support is indicated in malnourished cirrhotics, patients with severe alcoholic hepatitis, in liver transplant recipients before and after transplantation. In patients with hepatic encephalopathy and ascites nutritional treatment must be modified. Enteral nutrition is superior to parenteral, because it is cheaper, more physiological and it has less side effects. In acute liver failure both enteral and parenteral nutrition could be used.