Impact of malnutrition on nutritional and non nutritional factors in end Stage liver disease

Abstract

Background and Objective: Malnutrition has a negative effect on the outcome of liver transplantation surgery. However, there are very few studies focusing on association of nutrition status on nutritional and non-nutritional factors before the surgery which can further guide nutrition therapy and prevent nutrition mediated complications. The objective of study was to analyze the impact of nutrition status on both nutritional and non nutritional factors in patients with End Stage Liver Disease (ESLD). Materials and Methods: The study recruited 54 ESLD adult patients. Subjective Global Assessment was used for nutritional assessment. Nutritional factors like anthropometric profile, body composition, dietary intake, dietary advice received and consumption of dietary supplements were assessed. Non-nutritional factors like aetiology, severity of the disease [Child Turcotte Pugh (CTP) grades], degree of ascites, biochemical status, Quality of Life, Performance Status and functional inability were assessed during the course of study. The analysis was performed by SPSS version 17.0, associations between factors were analyzed by chi-square test and kruskal-wallis test with the significance level of < 0.05. Results: Majority (75.8%) of the patients were moderately malnourished while 9.1% were severely malnourished. Malnutrition in ESLD was significantly (p < 0.05) associated with non-nutritional factors like aetiology, CTP grade C, tense ascites, lower haemoglobin levels, higher functional inability, fatigue and lower grades of Performance Status. Also, nutritional factors like normal triceps levels, higher fat mass and body fat%, lower muscle mass and Fat Free Mass, higher weight loss and lower calorie intake were significantly (p < 0.05) associated to malnutrition. Conclusion: Nutritional status assessment is a crucial step in treatment of ESLD. The present study showed association of malnutrition with various nutritional and non-nutritional factors which could become major challenges in prognosis and treatment of ESLD patients.