Ernährung bei Leberzirrhose: wichtige Tipps für Klinik und Praxis

Abstract

Liver disease and nutritional status affect each other mutually. Hepatic function is impaired by malnutrition and can be improved by nutrition therapy. Liver cirrhosis leads to prognostically relevant malnutrition in a stage dependent manner. Protein depletion and sarcopenia are its key features. Patients with liver cirrhosis should undergo systematic screening for risk of malnutrition and if positive sarcopenia should be assessed and a nutrition plan devised. In cirrhotic patients, spontaneous food intake frequently does not meet requirements and prolonged (> 12 h) periods of fasting must be avoided. In a stepwise fashion nutritional counseling, oral nutritional supplements, enteral tube feeding and parenteral nutrition as third-line-therapy should be used. In cirrhotic patients, nutrition therapy can improve morbidity and mortality by ensuring the adequate provision of energy, protein and micronutrients.

Mangelernährung ist bei vielen Krankheiten ein unabhängiger Risikofaktor bezüglich Morbidität und Sterblichkeit. Zirrhosepatienten sind aufgrund von Eiweißmangel besonders gefährdet. Leberfunktionen werden durch Mangelernährung beeinträchtigt und können durch Ernährungstherapie wieder verbessert werden. Im nachfolgenden Beitrag werden die Bedeutung des Screenings auf Mangelernährung und die möglichen Therapien beleuchtet.

Schlüsselwörter

Enterale Ernährung - Parenterale Ernährung - Eiweißmangel - Sarkopenie - Gebrechlichkeit - Körperzusammensetzung

Key words

enteral nutrition - parenteral nutrition - protein malnutrition - sarcopenia - frailty - body composition

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