Laboratory tests for evaluating nutritional status in patients with cirrhosis

Testing for all patients

Complete blood count

Serum albumin

Serum creatinine

International normalized ratio (INR)

Serum 25-hydroxyvitamin D

C-reactive protein (CRP)

Additional testing for patients with any of the following:

Decompensated cirrhosis*
Alcohol-associated cirrhosis
Cirrhosis related to chronic cholestasis

Iron studies

Vitamin A

Vitamin B1 (Thiamine)^¶

Vitamin B12

Vitamin E

Magnesium

Phosphorus

Potassium

Folate

Zinc

Selenium

The tests and frequencies reflect the author's practice and may vary among clinicians. For most patients with cirrhosis, we typically perform these tests approximately every 6 to 12 months. For patients with decompensated cirrhosis, we perform testing more frequently (eg, every two to three months).

* Studies such as albumin and INR are affected by hepatic dysfunction. Thus, they are less likely to be independent markers of nutritional status in patients with decompensated cirrhosis.

¶ Refer to UpToDate content on water-soluble vitamins for additional details on limitations of assessing thiamine levels and approach to repletion.

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Laboratory tests for evaluating nutritional status in patients with cirrhosis