The effect of adding oral nutritional supplements to the nutrition on ascites protein and complement content in cirrhosis patients with ascites

AIM: It was aimed to determine the effect of adding oral nutritional supplements to the diet of patients with cirrhosis and developed ascites, on acid protein and complement levels and the development of spontaneous bacterial peritonitis. MATERIALS AND METHODS: Patients with cirrhosis who applied to Sakarya Training and Research Hospital Gastroenterology outpatient clinic between January and August 2022 or were hospitalized in the Gastroenterology service were screened. Among these patients, those who were referred to the nutrition outpatient clinic and who were started on a 30-35 kcal/kg/day diet or a 30-35 kcal/kg/day diet and oral nutritional supplement were included in the study. Anthropometric measurements of patients; SGA, NRS-2002, RFH-NPT, MAC, TST, SST, HG tests and height, weight and BMI measurements were performed and recorded. By performing paracentesis, acid acid C3, C4, total protein and albümin levels were measured. Baseline and 8th week data were analyzed. RESULTS: Twenty-three patients, 12 (52.2%) female and 11 (47.8%) male, were included. The age of the patients was 66.6±9.9 years. 6 (26.1%) patients had moderate and 17 (73.9%) severe ascites. There were 12 (52.2%) patients in the enteral nutrition group and 11 (47.8%) patients in the standard diet group. SBP developed in 12 patients in a 6-month period. There was a significant decrease in NRS-2002, RFH-NPT, SGA scores at the end of the treatment compared to the beginning in patients receiving enteral nutrition. There was no significant difference in HG, MAC, TST and SST measurements, between groups and within groups before and after treatment. There was no significant difference in acid total protein, C3 and C4 values between groups and within groups before and after treatment. At the end of the treatment, the acid albümin value in the standard diet group showed a significant decrease (p<0.05) compared to the baseline, and this decrease also showed a significant difference (p<0.05) compared to the albümin change in the enteral nutrition group. There was no significant difference between the groups in terms of SBP development. CONCLUSION: As a result, in our study, there was an increase in acid complement levels in the enteral nutrition group, although that increase would make a significant difference was not observed. The effectiveness of enteral nutrition in terms of SBP development has not been observed. Studies with more patients and longer follow-up periods are needed on this subject. Keywords: Ascites, cirrhosis, complement, nutrition, spontaneous bacterial peritonitis