Nutrition Support of Children With Chronic Liver Diseases

Mouzaki, Marialena; Bronský, Jiří; Gupte, Girish; Hojsak, Iva; Jahnel, Jörg; Pai, Nikhil; Quirós-Tejeira, Rubén E.; Wieman, Renee; Sundaram, Shikha S.

doi:10.1097/mpg.0000000000002443

Cited by 71 publications

(113 citation statements)

References 114 publications

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“…Special attention should be payed to infants because they have smaller glycogen stores and, consequently, a higher risk of hypoglycemia. 14 , 24 , 25 …”

Section: Resultsmentioning

confidence: 99%

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Metabolic and Nutritional Repercussions of Liver Disease on Children: How to Minimize Them?

Mazzoni

Lessa

Zamberlan

2022

Rev. paul. pediatr.

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Objective: To describe the metabolic and nutritional repercussions of chronic liver disease (CLD), proposing strategies that optimize nutritional therapy in the pre- and post-liver transplantation (LT) period, in order to promote favorable clinical outcomes and adequate growth and development, respectively. Data sources: Bibliographic search in the PubMed, Lilacs and SciELO databases of the last 12 years, in English and Portuguese; target population: children from early childhood to adolescence; keywords in Portuguese and their correlates in English: “Liver Transplant,” “Biliary Atresia,” “Nutrition Therapy,” “Nutritional Status,” and “Child”; in addition to Boolean logics “and” and “or,” and the manual search of articles. Data synthesis: Malnutrition in children with CLD is a very common condition and an important risk factor for morbidity and mortality. There is an increase in energy and protein demand, as well as difficulties in the absorption of carbohydrates, lipids and micronutrients such as fat-soluble vitamins and some minerals. An increase in the supply of energy, carbohydrates and proteins and micronutrients, especially fat-soluble vitamins, iron, zinc and calcium, is suggested, except in cases of hepatic encephalopathy (this restriction is indicated for a short period). Conclusions: Based on metabolic changes and anthropometric and body composition monitoring, a treatment plan should be developed, following the nutritional recommendations available, in order to minimize the negative impact of malnutrition on clinical outcomes during and after LT.

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“…Special attention should be payed to infants because they have smaller glycogen stores and, consequently, a higher risk of hypoglycemia. 14 , 24 , 25 …”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, these metabolic changes are suggestive of a possible imbalance in the supply of carbohydrates in the diet, which must always be adjusted and balanced. 16 , 21 , 23 , 24 …”

Section: Resultsmentioning

confidence: 99%

Metabolic and Nutritional Repercussions of Liver Disease on Children: How to Minimize Them?

Mazzoni

Lessa

Zamberlan

2022

Rev. paul. pediatr.

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“…Chronic liver disease is a very common clinical disease. Stages of liver disease include hepatitis or steatosis and hepatic stasis, brosis, cirrhosis, and cellular hepatocellular carcinoma (HCC) (1)(2)(3)(4). The goal of treatment is to stop the progression of the disease and its complications and the need for a multidisciplinary approach.…”

mentioning

confidence: 99%

“…The effect that chronic liver disease has on the nutritional status and health of the child is determined by the cause and severity of liver disease and the age of onset. There is a two-way interaction between CLD and malnutrition: CLD often leads to malnutrition, and malnutrition negatively affects the course of liver disease (2)(3)(4)(5). Gradual loss of liver function and cirrhosis in children with CLD cause hemodynamic and metabolic disorders and severe complications such as liver and lung syndrome and renal failure.…”

mentioning

confidence: 99%

“…However, even children with less liver disease need nutritional evaluation and intervention to prevent osteoporosis and the effects of micronutrient de ciency (2). Current recommendations based on our understanding of the effect of CLD on nutritional status, digestion and absorption of nutrients, metabolism, and clinical trials are limited (1)(2)(3)(4)(5). The prognostic and therapeutic role of nutritional issues in the management of patients with liver disease has long been known, and therefore, nutritional status was one of the main prognostic score variables designed by Child and Turcotte (2).…”

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confidence: 99%

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The effect of specific nutritional modification program on specific liver findings in children with chronic liver disease: A clinical trial

Jafari

Rezaeian

Nomjuo

et al. 2020

Preprint

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Background: Liver disease leads to complex pathophysiological injuries that affect digestion, absorption, distribution, storage and use of food. The effect that chronic liver disease has on the nutritional status and health of the child is determined by the cause and severity of liver disease and the age of onset of liver disease. As liver disease progresses, so do the symptoms and complications of the disease. The aim of this study was to determine the effect of specific nutrition adjustment program on specific liver findings in children with chronic liver disease.Methods: In this clinical trial study, 75 children with chronic liver disease were randomly divided into two groups (45 in the intervention group and 30 in the control group). At the beginning of the study, the necessary experiments were taken from two groups. The intervention group received a nutritional adjustment program during 6 sessions of the workshop. After 12 weeks of follow-up, bilirubin level (total, direct), albumin level, PT, INR, transaminases (AST, ALT) were measured in both groups. Data analysis was performed using SPSS software version 16 and Wilcoxon and Mann-Whitney tests.Results: At the beginning of the study, both groups were homogeneous in terms of demographic variables. In the post-intervention stage compared to the pre-intervention stage in the intervention group, the mean scores of prothrombin time (P = 0/040), albumin (P = 0/007), aspartate transaminase and alanine transaminase (p˂0/001)were statistically significant:. But the mean score of total bilirubin (P = 0/063) in the post-intervention stage compared to before the intervention in the intervention group was not statistically significant.Conclusion: Nutrition education and encouragement of patients with chronic liver disease to follow a special diet can be an important factor in feeling healthy and preventing the progression of the disease.Trial registration: Name of registry: Zahra NamjouIRCT registration number: IRCT2015091424019N1 Registration date: 2016-01-30 Registration timing: retrospective

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Cholestatic liver diseases of genetic etiology: Advances and controversies

et al. 2022

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With the application of modern investigative technologies, cholestatic liver diseases of genetic etiology are increasingly identified as the root cause of previously designated “idiopathic” adult and pediatric liver diseases. Here, we review advances in the field enhanced by a deeper understanding of the phenotypes associated with specific gene defects that lead to cholestatic liver diseases. There are evolving areas for clinicians in the current era specifically regarding the role for biopsy and opportunities for a “sequencing first” approach. Risk stratification based on the severity of the genetic defect holds promise to guide the decision to pursue primary liver transplantation versus medical therapy or nontransplant surgery, as well as early screening for HCC. In the present era, the expanding toolbox of recently approved therapies for hepatologists has real potential to help many of our patients with genetic causes of cholestasis. In addition, there are promising agents under study in the pipeline. Relevant to the current era, there are still gaps in knowledge of causation and pathogenesis and lack of fully accepted biomarkers of disease progression and pruritus. We discuss strategies to overcome the challenges of genotype–phenotype correlation and draw attention to the extrahepatic manifestations of these diseases. Finally, with attention to identifying causes and treatments of genetic cholestatic disorders, we anticipate a vibrant future of this dynamic field which builds upon current and future therapies, real‐world evaluations of individual and combined therapeutics, and the potential incorporation of effective gene editing and gene additive technologies.

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Nutrition Support of Children With Chronic Liver Diseases

Abstract: WHO child growth standards : training course on child growth assessment. "The project was designed and coordinated by Adelheid W. Onyango and Mercedes de Onis ..

Cited by 71 publications

References 114 publications

Metabolic and Nutritional Repercussions of Liver Disease on Children: How to Minimize Them?

Metabolic and Nutritional Repercussions of Liver Disease on Children: How to Minimize Them?

The effect of specific nutritional modification program on specific liver findings in children with chronic liver disease: A clinical trial

Cholestatic liver diseases of genetic etiology: Advances and controversies

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