Jad Baki1, Patrick Brown1, Elliot B Tapper1. 1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
Abstract
PURPOSE OF REVIEW: Ascites is a common, morbid complication of cirrhosis. Nutritional interventions such as sodium-restriction and high-protein diet are considered standard of care. However, their evidence base is limited. We performed a systematic review of randomized trials of nutritional interventions for ascites. RECENT FINDINGS: Increasing consumption of calories and protein alone was ineffective. Studies reached contradictory conclusions regarding sodium restriction in patients taking combination diuretics. Intravenous amino acid infusion alone did not improve outcomes, peripheral parenteral nutrition did not improve outcomes except alone but reduced mortality in conjunction with branched-chain amino acid evening snack. SUMMARY: Patients may benefit from sodium restriction and a protein-rich evening snack. Future trials should prioritize standardizing nutritional targets and tailoring interventions to the specific needs of patients including the socioeconomic factors impacting adherence.
PURPOSE OF REVIEW: Ascites is a common, morbid complication of cirrhosis. Nutritional interventions such as sodium-restriction and high-protein diet are considered standard of care. However, their evidence base is limited. We performed a systematic review of randomized trials of nutritional interventions for ascites. RECENT FINDINGS: Increasing consumption of calories and protein alone was ineffective. Studies reached contradictory conclusions regarding sodium restriction in patients taking combination diuretics. Intravenous amino acid infusion alone did not improve outcomes, peripheral parenteral nutrition did not improve outcomes except alone but reduced mortality in conjunction with branched-chain amino acid evening snack. SUMMARY: Patients may benefit from sodium restriction and a protein-rich evening snack. Future trials should prioritize standardizing nutritional targets and tailoring interventions to the specific needs of patients including the socioeconomic factors impacting adherence.
Authors: Elliot B Tapper; Fasiha Kanwal; Sumeet K Asrani; Chanda Ho; Nadia Ovchinsky; John Poterucha; Avegail Flores; Judith E Smith; Victor Ankoma-Sey; Bruce Luxon; Michael L Volk Journal: Hepatology Date: 2018-04-19 Impact factor: 17.425
Authors: Scott L Hummel; Wahida Karmally; Brenda W Gillespie; Stephen Helmke; Sergio Teruya; Joanna Wells; Erika Trumble; Omar Jimenez; Cara Marolt; Jeffrey D Wessler; Maria L Cornellier; Mathew S Maurer Journal: Circ Heart Fail Date: 2018-08 Impact factor: 8.790
Authors: A Gauthier; V G Levy; A Quinton; H Michel; B Rueff; L Descos; J P Durbec; J Fermanian; S Lancrenon Journal: Gut Date: 1986-06 Impact factor: 23.059
Authors: Lauren A Beste; Steven L Leipertz; Pamela K Green; Jason A Dominitz; David Ross; George N Ioannou Journal: Gastroenterology Date: 2015-08-05 Impact factor: 22.682
Authors: M Bernardi; G Laffi; M Salvagnini; G Azzena; S Bonato; F Marra; F Trevisani; G Gasbarrini; R Naccarato; P Gentilini Journal: Liver Date: 1993-06
Authors: Seth A Berkowitz; Jean Terranova; Caterina Hill; Toyin Ajayi; Todd Linsky; Lori W Tishler; Darren A DeWalt Journal: Health Aff (Millwood) Date: 2018-04 Impact factor: 6.301