Hampsey and K B Schwarz Johns Hopkins

School of Medicine, Baltimore, MD, USA

© 2005 Elsevier Ltd. All rights reserved.

This article covers the role of the liver in normal nutrition, including the important functions of bile salt production, macronutrient metabolism, and fat-soluble vitamin absorption, metabolism, and storage. Next, the pathogenesis of malnutrition in liver disease is discussed, starting with the mechanisms of malnutrition in both acute and chronic liver failure. Specific nutritional issues in liver failure are addressed, including metabolic disturbances of carbohydrates, protein, and fats. Nutritional disturbances in the major types of specific liver diseases are reviewed: hepatocellular, metabolic liver disease, and biliary tract disorders. Nutritional assessment and management of patients with acute, chronic liver disease and end stage liver disease are discussed.

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