Final answer:
Arginine supplementation should be used with caution in cirrhotic patients due to their compromised liver function which can be exacerbated by increased levels of ammonia that arginine supplementation might produce.
Step-by-step explanation:
Arginine supplementation should be used most cautiously in cirrhotic patients. Cirrhosis is a chronic liver disease often associated with an increased ammonia level due to the liver's reduced ability to convert ammonia to urea. Arginine is involved in the urea cycle, which can generate more ammonia when supplemented, potentially worsening hepatic encephalopathy, a complication of liver cirrhosis. Therefore, cautious use is warranted as it can exacerbate an already compromised situation.
Patients with other systemic disorders like diabetes mellitus, malnutrition, hepatitis, or HIV infection may also merit careful consideration when contemplating arginine supplementation. Additionally, those undergoing immunosuppressive treatments such as cytotoxic chemotherapy, bone marrow ablation, or radiation therapy, as well as patients with prolonged critical illness due to infection, surgery, or trauma, especially if they are very young, elderly, or hospitalized, should have their condition monitored closely if receiving this supplement.