For ascites, what is the recommended protein intake for repletion?

• A. 1.3-2.0 g/kg/day
• B. 0.5-0.8 g/kg/day
• C. 2.5-3.0 g/kg/day
• D. 0.8-1.2 g/kg/day

Answer: (A)

In ascites due to liver disease, the goal is to restore protein stores and support lean body mass rather than restricting protein. The body in cirrhosis is often in a hypercatabolic state with increased protein breakdown, so providing enough protein is essential for nitrogen balance, immune function, and wound healing. The recommended range for repletion is about 1.3 to 2.0 g/kg/day, which accounts for variability in malnutrition severity and patient tolerance. Starting around the lower end (roughly 1.3–1.5 g/kg/day) and increasing toward 2.0 g/kg/day as tolerated helps rebuild protein stores without precipitating complications. The other options are either too low to correct malnutrition or excessively high for routine repletion without careful monitoring.