title: Optimizing nutritional management in children with chronic liver disease.
abstract: Malnutrition is common in infants and children with chronic liver disease (CLD) and may easily be underestimated by clinical appearance alone. The cause of malnutrition in CLD is multifactorial, although insufficient dietary intake is probably the most important factor and is correctable. Fat malabsorption occurs in cholestatic disorders, and one must also consider any accompanying fat-soluble vitamin and essential fatty acid deficiencies. The clinician should proactively evaluate, treat, and re-evaluate response to treatment of nutritional deficiencies. Because a better nutritional state is associated with better survival before and after liver transplantation, aggressive nutritional management is an important part of the care of these children.
authors.affiliation: SickKids Transplant Center, Division of Gastroenterology, Hepatology, and Nutrition, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
authors.forename: Scott
authors.initials: S
authors.lastname: Nightingale
authors.forename: Vicky Lee
authors.initials: VL
authors.lastname: Ng
mesh_terms: D000293:Adolescent; D001481:Basal Metabolism; D001646:Bile / Q000378:metabolism; D001660:Biliary Tract Diseases / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D002779:Cholestasis / Q000150:complications / Q000378:metabolism; D002908:Chronic Disease; D004040:Dietary Carbohydrates / Q000378:metabolism; D004041:Dietary Fats / Q000378:metabolism; D004044:Dietary Proteins / Q000378:metabolism; D019587:Dietary Supplements; D004064:Digestive System / Q000378:metabolism / Q000503:physiopathology*; D002149:Energy Intake; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000378:metabolism*; D044342:Malnutrition / Q000178:diet therapy* / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D018977:Micronutrients / Q000378:metabolism*; D015596:Nutrition Assessment; D014131:Trace Elements / Q000378:metabolism; D014815:Vitamins / Q000378:metabolism
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D018977:Micronutrients; D014131:Trace Elements; D014815:Vitamins