Effects of ascites resolution after successful TIPS on nutrition in cirrhotic patients with refractory ascites.
OBJECTIVE
Malnutrition is common in patients with decompensated cirrhosis and refractory ascites. The use of transjugular intrahepatic portosystemic stent shunt (TIPS) is effective in eliminating ascites. The purpose of this study was to investigate the effect of TIPS and resolution of refractory ascites on the nutritional status of patients with decompensated cirrhosis.


METHODS
Fourteen consecutive patients with refractory ascites and a Pugh score of 9.0+/-0.5 had a TIPS insertion. Biochemical data, resting energy expenditure (REE), total body nitrogen (TBN), body potassium (TBK), body fat (TBF), muscle force (MF), and food intake were recorded before TIPS, and at 3 and 12 months after the procedure.


RESULTS
Ten patients completed the study. Baseline values for REE, TBN, TBF, MF, and energy intake were below normal at baseline. There was a significant increase in dry weight, TBN, and REE at 3 and 12 months compared with baseline. TBF improved significantly at 12 months. There was a trend toward an increase in energy intake (p = 0.072). There was no change in protein intake, TBK, MF, and Pugh score.


CONCLUSIONS
In cirrhotic patients with refractory ascites, resolution of the ascites after TIPS placement resulted in improvement of several nutritional parameters, especially for body composition.
Allard
J P
JP
Division of Gastroenterology, Toronto General Hospital, University of Toronto, Ontario, Canada.
Chau
J
J
Sandokji
K
K
Blendis
L M
LM
Wong
F
F
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001201:Ascites / Q000209:etiology / Q000601:surgery*; D001823:Body Composition; D002153:Calorimetry, Indirect; D004558:Electric Stimulation; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology; D009584:Nitrogen / Q000378:metabolism; D009752:Nutritional Status; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011188:Potassium / Q000378:metabolism; D016896:Treatment Outcome
D009584:Nitrogen; D011188:Potassium