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Updated: Jul 14, 2026

The Murine Choline-Deficient, Ethionine-Supplemented (CDE) Diet Model of Chronic Liver Injury
Published on: October 21, 2017
[Nutrition in liver cirrhosis]
Felix Gundling1, Niels Teich, Hendrik Martin Strebel
1Klinik für Gastroenterologie, Hepatologie und Gastroenterologische Onkologie, Städtisches Klinikum München GmbH, Klinikum Bogenhausen, München. Felix.Gundling@GMX.de
Background:
Malnutrition is highly prevalent among patients with liver cirrhosis. This includes the supply with macronutrients and micronutrients. The pathogenesis is variable and often depends on metabolic characteristics and complications of the chronic liver disease. A reduced nutritional status, i.e., protein and energy malnutrition, has prognostic significance resulting in an increased morbidity and mortality rate. The assessment of malnutrition is frequently a major problem in daily practice.
Conclusion:
A sufficient daily energy supply should be guaranteed in patients with liver cirrhosis, which is higher compared to the normal population. Furthermore, the increased turnover of amino acids requires a sufficient protein supplementation. Ascites may benefit from a restriction of daily low-salt fluid intake. Additional substitution of vitamins and trace elements is indicated when symptoms of deficiency are apparent. Associated hepatic osteopathy is a frequent complication of liver cirrhosis. Nutritional advice in patients with cirrhosis requires an individual management regarding the dominating complications of the disease.
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