A higher-than-usual dietary intake with protein
amount of 1.2 to 1.5 g/kg and kilocalorie intake of 35 to
40 kcal/kg is recommended.83 This recommendation by the
American Association for the Study of Liver Diseases and
the American College of Gastroenterology is based on a
study in patients with cirrhosis,89 and such approaches were
found to improve the efficiency of nitrogen metabolism
and then reduce hospitalization as well as complications.27
It is also recommended that patients could have protein
amount of 1.5 g/kg and kilocalorie intake of 40 kcal/kg
during acute illness or intermittent exacerbation of chronic
disease.83 Branched-chain amino acids may be considered
in patients who develop encephalopathy during protein
feeding