Abstract
Assessment of nutritional status in cirrhotic patients is very difficult, and there is no gold-standard method used for nutritional evaluation of these patients. The study aims to assess the role of creatinine height index in evaluation of nutritional status of patients with liver cirrhosis, and to compare its results with different ordinary methods used for nutritional assessment. The study was cross sectional observational study, carried out at El-Rajhi Liver Hospital and internal medicine department in Assiut University on 103 patients with liver cirrhosis after obtaining their informed consent form May to September 2015. 24 h urine collection was obtained from all patients, then measurement of their urine creatinine was done, after that, creatinine height index (CHI) was calculated for every patient, furthermore, All patients did the followings investigations: Serum albumin, Anthropometric measurements, Subjective Global Assessment. Then its results were compared with their CHI. According to CHI, malnutrition was present in 89.2% of patients: 11 patients (11.8%) were mildly malnourished, 38 (40.8%) were moderately malnourished and 35 (36.6%) were severely malnourished, Subjective Global Assessment detects malnutrition in 92.2% of patients. Furthermore, 87.4% of the patients were malnourished according to Mid Arm Muscle Circumference while 86.4% of them were malnourished according to Triceps Skin Fold Thickness. Mean value of CHI was decreased markedly from 86.1, 64.5 to 39.1% in Child score A, B and C respectively (P value= 0.000). CHI is a good predictor of muscle mass in patients with liver cirrhosis. Key words: CHI, nutritional status, liver, cirrhosis, assessment.
Highlights
Liver cirrhosis results from different mechanisms of liver injury among which nutritional factors may be claimed (Schuppan and Afdhal 2008), and clinically, cirrhosis has been regarded as an end-stage disease that invariably leads to death, unless liver transplantation is done (D’Amico et al, 2006)
Protein-calorie malnutrition is a common complication of liver cirrhosis in Egyptian patients
Nutritional disorders appeared to be related to the degree of liver injury and nutritional status is good in early stages of liver cirrhosis, and deteriorates in end stage liver disease
Summary
Liver cirrhosis results from different mechanisms of liver injury among which nutritional factors may be claimed (Schuppan and Afdhal 2008), and clinically, cirrhosis has been regarded as an end-stage disease that invariably leads to death, unless liver transplantation is done (D’Amico et al, 2006). It is well documented that liver performs essential functions in food digestion and in absorption, metabolism, storage, transport, activation and utilization of nutrients Compromising these functions in patients with liver cirrhosis can result in the development of protein calorie malnutrition (PCM) (Moriwaki, 2002). Increased rates of septic complications, poorer quality of life, and a reduced life span have all been observed in cirrhotic with poorer nutritional status compared to those with good nutritional status (Dan et al, 2008)
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