MALNUTRITION AND LIVER INSUFFICIENCY IN C HRONIC LIVER-DISEASE

Background: Malnutrition is often associated with chronic liver diseas e, particularly in alcoholics. Its objetive assessment by means of met hods which are useful and accessible to daily clinical practice is now adays considered to be necessary for an adequate diagnosis and treatme nt of these problems, being also a necessary requirement in the select ion of the candidates for a liver transplant. Besides, the still insuf ficiently known relation between nutritional status and the degree of liver dysfunction is of great interest, which has given rise to the pr esent study. Patients and Methods: The level of malnutrition and of he patic function of 48 patients suffering from chronic liver disease hos pitalized in Internal Medicine is evaluated, by means of the Ratio of Protein-Caloric Malnutrition proposed by Pomar et al and the Ratio obt ained from Clinical and Laboratory data proposed by Orrego et al, resp ectively. Results: All the patients showed different levels of malnutr ition, 27% of the cases being severe, 69% moderate and the remaining 4 % mild. The serum albumin and the response to cutaneous antigens were the most frequently altered tests, while the brachial muscular extent was the less altered parameter. A lineal correlation between the degre e of malnutrition and that of liver dysfunction (r=0.3998, p<0.01) is also made evident. Conclusions: Malnutrition is often associated with chronic liver disease, is of mixed characteristics (marasmus and Kwash iorkor disease), and seems to aggravate with the progression of the li ver dysfunction.