Micronutrient deficiencies in hepatic cirrhosis: Navigating challenges to assessment and implications for clinical management: A narrative review

Patients with cirrhosis are prone to malnutrition and a range of micronutrient deficiencies, which carry adverse health effects and the potential to worsen liver-specific outcomes. Clinicians may rely heavily on serum or plasma concentrations of micronutrients for information regarding nutritional status. However, these values can be skewed due to factors such as inflammation as well as the underlying liver dysfunction, affecting the accuracy of interpretation and posing concern for overtreatment. This review summarizes the risk factors for vitamin and mineral deficiencies in patients with cirrhosis, describes the challenges associated with micronutrient assessment, and discusses considerations for initiating micronutrient replacement therapy.