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Journal of Nutrition and Metabolism
Volume 2010, Article ID 489823, 12 pages
Review Article

Role of Nutrition in the Management of Hepatic Encephalopathy in End-Stage Liver Failure

1Neuroscience Research Unit, CHUM, Saint-Luc Hospital, University of Montreal, 1058 St-Denis Street, Montreal, QC, Canada
2Department of Nutrition, University of Montreal, Montreal, QC, Canada

Received 9 July 2010; Accepted 11 November 2010

Academic Editor: Linda J. Wykes

Copyright © 2010 Chantal Bémeur et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Malnutrition is common in patients with end-stage liver failure and hepatic encephalopathy, and is considered a significant prognostic factor affecting quality of life, outcome, and survival. The liver plays a crucial role in the regulation of nutrition by trafficking the metabolism of nutrients, their distribution and appropriate use by the body. Nutritional consequences with the potential to cause nervous system dysfunction occur in liver failure, and many factors contribute to malnutrition in hepatic failure. Among them are inadequate dietary intake, malabsorption, increased protein losses, hypermetabolism, insulin resistance, gastrointestinal bleeding, ascites, inflammation/infection, and hyponatremia. Patients at risk of malnutrition are relatively difficult to identify since liver disease may interfere with biomarkers of malnutrition. The supplementation of the diet with amino acids, antioxidants, vitamins as well as probiotics in addition to meeting energy and protein requirements may improve nutritional status, liver function, and hepatic encephalopathy in patients with end-stage liver failure.