Hepatic, gut, and renal substrate flux rates in patients with hepatic cirrhosis.

Abstract in brief

• The study examined how the liver, gut, and kidneys contribute to maintaining energy balance in patients with severe hepatic cirrhosis, focusing on the flux rates of various fuels like fatty acids, ketone bodies, triglycerides, and glucose.
• Results showed that in cirrhotic patients, hepatic glycogen stores were depleted, and energy production shifted toward increased gluconeogenesis and ketogenesis, especially after fasting, mimicking starvation responses.
• Despite these changes, average renal glucose contribution was absent, and the overall metabolic shift in cirrhosis after fasting resembled that of normal individuals experiencing advanced starvation, highlighting altered but adaptive fuel homeostasis in cirrhotic livers.