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Background: Protein-energy wasting (PEW) is the chronic kidney disease (CKD)-specific diagnosis encompassing malnutrition. PEW is associated with adverse outcomes, including those receiving peritoneal dialysis (PD). Identifying PEW requires accurate methods to improve diagnosis.

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People with advanced chronic liver disease (ACLD) have an enhanced risk of malnutrition, which has multifactorial etiology and is mainly linked to a reduced energy and protein intake; malnutrition is critical for patients with cirrhosis since it is often associated with sarcopenia, a skeletal muscle depletion with a loss of muscle mass and function. Late-evening snacks have been extensively studied, and guidelines are recommended to counteract the effects of prolonged fasting at night in patients with ACLD. However, it has not been fully explored whether late evening snacking is clarified as a milestone to address the nutritional needs of people with ACLD or whether it has a potential role in improving body composition.

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