Branched-chain amino acid treatment in patients with liver cirrhosis

Hepatology Research : the Official Journal of the Japan Society of Hepatology
Kazuyuki SuzukiMasakatsu Iwai

Abstract

We discuss branched-chain amino acid (BCAA) treatment for the management of hepatic encephalopathy (HE) and protein-energy malnutrition (PEM) in patients with liver cirrhosis (LC). PEM is closely associated with the prognosis of patients with LC independently of liver function. Therefore, adequate protein and energy intake is a fundamental management to improve the status of PEM in patients with LC. However, it is difficult to maintain good nutritional status with diet therapy alone in patients with LC, because the majority of these patients have disturbances of the nutritious metabolism including urea synthesis in the liver, together with the existence of portal-systemic shunt which is related with the pathogenesis of HE. BCAA enriched amino acid solution was administered at first to treat chronic HE based on amino acid imbalance and neurotransmitter theory. Furthermore, recent studies have suggested that the supplement of BCAA enriched oral mixture and BCAA granules with diet therapy might improve the status of PEM in patients with LC. However, as the effects of these BCAA supplements are basically related to the severity of liver damage, further investigations are required to identify the efficacy of these treatments.

Citations

Jun 16, 2010·Journal of Gastroenterology and Hepatology·Hisataka MoriwakiYoichi Terakura
Jul 18, 2008·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Takumi KawaguchiMichio Sata
Jun 5, 2015·Journal of Clinical and Experimental Hepatology·Chantal Bémeur, Roger F Butterworth
Mar 11, 2015·Journal of Clinical and Experimental Hepatology·Swastik Agrawal, Radha K Dhiman
Nov 1, 2011·JPEN. Journal of Parenteral and Enteral Nutrition·Yoshihiro KadotaYoshiharu Shimomura
Aug 16, 2013·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Takumi KawaguchiMichio Sata
May 18, 2012·The Cochrane Database of Systematic Reviews·Ronald L KoretzTimothy O Lipman
Nov 2, 2018·Journal of Nutritional Science and Vitaminology·Kazuto TajiriToshiro Sugiyama
Mar 11, 2015·Journal of Clinical and Experimental Hepatology·Chantal Bémeur, Roger F Butterworth

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