Journal of Hepatology
Volume 41, Issue 1 , Pages 38-43 , July 2004

Normal protein diet for episodic hepatic encephalopathy: results of a randomized study

  • Juan Córdoba

      Affiliations

    • Servei de Medicina Interna-Hepatologia, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
    • Corresponding Author InformationCorresponding author. Tel.: +34-93-274-6140; fax: +34-93-274-6068
  • ,
  • Juan López-Hellı́n

      Affiliations

    • Centre d'Investigacions en Bioquı́mica i Biologia Molecular, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
  • ,
  • Mercé Planas

      Affiliations

    • Unitat de Suport Nutricional, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
  • ,
  • Pilar Sabı́n

      Affiliations

    • Servei de Farmacia, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
  • ,
  • Francesc Sanpedro

      Affiliations

    • Servei de Medicina Interna-Hepatologia, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
  • ,
  • Francisco Castro

      Affiliations

    • Servei de Medicina Interna-Hepatologia, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
  • ,
  • Rafael Esteban

      Affiliations

    • Servei de Medicina Interna-Hepatologia, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
  • ,
  • Jaume Guardia

      Affiliations

    • Servei de Medicina Interna-Hepatologia, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain

Received 29 October 2003 ,Revised 17 February 2004 ,Accepted 5 March 2004.

References 

  1. Blei AT, Cordoba J. Hepatic encephalopathy. Am J Gastroenterol. 2001;96:1968–1976
  2. Riordan SM, Williams R. Treatment of hepatic encephalopathy. N Engl J Med. 1997;337:473–479
  3. Plauth M, Merli M, Kondrup J. Management of hepatic encephalopathy. N Eng J Med. 1997;337:1921–1922
  4. Mullen KD, Weber FL. Role of nutrition in hepatic encephalopathy. Semin Liver Dis. 1991;11:292–304
  5. Kondrup J, Mueller MJ. Energy and protein requirements of patients with chronic liver disease. J Hepatol. 1997;27:239–247
  6. Merli M, Riggio O, Dally L. PINC. Does malnutrition affect survival in cirrhosis?. Hepatology. 1996;23:1041–1046
  7. Kearns PJ, Young H, Garcia G, Blaschke T, O'Hanlon G, Rinki M, et al.  Accelerated improvement of alcoholic liver disease with enteral nutrition. Gastroenterology. 1992;102:200–205
  8. Plauth M, Merli M, Weimann A, Ferenci P, Mueller MJ. ESPEN guidelines for nutrition in liver disease and transplantation. Clin Nutr. 1997;16:43–55
  9. Cabre E, Gonzalez-Huix F, Abad-Lacruz A, Esteve M, Acero D, Fernandez-Banares F, et al.  Effect of a total enteral nutrition on the short-term outcome of severly malnourished cirrhotics. Gastroenterology. 1990;98:715–720
  10. Akriviadis E, Botla R, Briggs W, Han S, Reynolds T, Shakil O. Pentoxifylline improves short-term survival in severe acute alcoholic hepatitis: a double blind, placebo-controlled trial. Gastroenterology. 2000;119:1637–1648
  11. Anonymous . Hepatic encephalopathy. In:  Sherlock S,  Dooley J editor. Diseases of the liver and the biliary system. 9th ed.. Oxford: Blackwell Scientific; 1993;p. 86–101
  12. Atterbury CE, Maddrey WC, Conn HO. Neomycin–sorbitol and lactulose in the treatment of acute portal-systemic encephalopathy. Am J Dig Dis. 1978;23:398–406
  13. Ferenci P, Lockwood AH, Mullen KD, Tarter RE, Weissenborn K, Blei AT, et al.  Hepatic encephalopathy–definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congress of Gastroenterology, Vienna, 1998. Hepatology. 2002;35:716–721
  14. Lopez-Hellin J, Lopez-Lara M, Mercader S, Gemar E, Garcia-Arumi E, Sabin P, et al.  Early curbing of protein hypercatabolism in postoperative patients by nutritional support with glucose plus amino acids, but not with glucose alone. Clin Nutr. 1997;16:67–73
  15. Simmons F, Goldstein H, Boyle JD. A controlled clinical trial of lactulose in hepatic encephalopathy. Gastroenterology. 1970;59:827–832
  16. Butterworth RF. The neurobiology of hepatic encephalopathy. Semin Liver Dis. 1996;16:235–244
  17. Phillips GB, Schwartz R, Gabduzda GJ, Davidson CS. The syndrome of impending hepatic coma in patients with cirrhosis of the liver given certain nitrogenous substances. N Eng J Med. 1952;247:239–246
  18. Damink SWMO, Jalan R, Redhead DN, Hayes PC, Deutz NE, Soeters PB. Interorgan ammonia and amino acid metabolism in metabolically stable patients with cirrhosis and a TIPSS. Hepatology. 2002;36:1163–1171
  19. Hamberg O, Nielsen K, Vilstrup H. Effects of an increase in protein intake on hepatic efficacy for urea synthesis in healthy subjects and in patients with cirrhosis. J Hepatol. 1992;14:237–243
  20. Kondrup J, Nielsen K, Juul A. Effect of long-term refeeding on protein metabolism in patients with cirrhosis of the liver. Br J Nutr. 1997;77:197–212
  21. Swart GR, van den Berg JWO, van Vuure JK, Rietveld T, Wattimena DL, Frenkel M. Minimum protein requirements in liver cirrhosis determined by nitrogen balance measurements at three levels of protein intake. Clin Nutr. 1989;8:329–336
  22. Deutz NE, Wagenmakers AJM, Soeters PB. Discrepancy between muscle and whole body protein turnover. Curr Opin Clin Nutr Metab Care. 1999;2:29–32
  23. McCullough AJ. Malnutrition in liver disease. Liver Transplant. 2000;6:S85–S96
  24. Marchesini G, Bianchi G, Merli M, Amodio P, Panella C, Loguercio C, et al.  Nutritional supplementation with branched-chain amino acids in advanced cirrhosis: a double-blind randomized trial. Gastroenterology. 2003;124:1792–1801
  25. Selberg O, Bottcher D, Tusch G, Pichlmayr R, Henkel E, Muller MJ. Identification of high- and low-risk patients before liver transplantation: a prospective cohort study of nutritional and metabolic parameters in 150 patients. Hepatology. 1997;25:652–657
  26. Soulsby CT, Morgan MY. Dietary management of hepatic encephalopathy in cirrhotic patients: survey of current practice in United Kingdom. Br Med J. 1999;318:1391
  27. Seymour CA, Whelan K. Dietary management of hepatic encephalopathy. Too many myths persist. Br Med J. 1999;318:1364–1365

PII: S0168-8278(04)00160-6

doi: 10.1016/j.jhep.2004.03.023

Journal of Hepatology
Volume 41, Issue 1 , Pages 38-43 , July 2004