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Liver Disease (Lab work (Glucose (high or low), GGT, AST (increased), ALT…
Liver Disease
Lab work
Glucose (high or low)
GGT
AST (increased)
ALT (normal or mildly elevated)
INR
Bilirubin (often elevated)
Serum ammonia (elevated?)
Blood urea nitrogen (BUN) (low?)
Albumin (low?)
CRP
Triglycerides (increased?)
Cholesterol (increased or decreased)
WBC
Serum B12 and folate
Plasma homocysteine (high?)
Na+, K+
Hemoglobin and hematocrit (decreased)
Serum iron, ferritin
Transferrin
Uric acid (UA) (increased)
Globulin
ALP (mildly elevated)
Mg (decreased), Ca
Serum PO4 (decreased)
Intervention
Food and Nutrition
Avoid alcohol
Malnourished pts: HPHE
HTN pts: DASH diet
Supplement micronutrient deficiencies
Small frequent meals (incl. before bed)
Requirements
Ascites: 1-1.5L fluid restriction
EER: 147-164kJ/kg (ASPEN guidelines)
EPR: ??
Cirrhosis
Hepatic Failure
Hepatic Encephalopathy