Sarcopenia secundaria en la encefalopatía hepática: Implicaciones para el seguimiento nutricional

Lucía de Nobili

Sarcopenia secundaria en la encefalopatía hepática: Implicaciones para el seguimiento nutricional

Lucía de Nobili

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Resumen

La encefalopatía hepática (EH) es una complicación frecuente, a la vez que una de las manifestaciones más debilitantes, de la cirrosis hepática (CH): la etapa última de la enfermedad hepática crónica. La EH se asocia con trastornos del metabolismo del amoníaco y la inflamación sistémica como principales mecanismos fisiopatológicos. La desnutrición en los pacientes cirróticos es elevada, y suele llegar a ser del 90 % en las fases últimas de la enfermedad hepática. La adecuada evaluación, atención y monitoreo de los aspectos nutricionales de los pacientes cirróticos son fundamentales para mejorar la calidad de vida de ellos, y aminorar las consecuencias de la enfermedad. En la siguiente revisión se describen los métodos de evaluación y seguimiento nutricionales del paciente cirrótico, las recomendaciones nutricionales y dietéticas a tener en cuenta en todas las fases de la EH, con particular énfasis en los cuadros de descompensación aguda; así como el tratamiento médico-nutricional orientado a la mejoría de los síntomas presentes. Mención especial se hace de las repercusiones de la sarcopenia secundaria en los pacientes cirróticos.

Palabras clave

Encefalopatía hepática; Cirrosis hepática; Hepatopatías; Nutrición; Sarcopenia

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