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2016 ; 5
(2
): 125-130
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Hemodiafiltration for hepatic encephalopathy induced by Budd-Chiari syndrome in a
patient with end-stage kidney disease
#MMPMID28508963
Wakamatsu T
; Yamamoto S
; Kamimura K
; Nakatsue T
; Iino N
; Iguchi S
; Kaneko Y
; Goto S
; Kazama JJ
; Narita I
CEN Case Rep
2016[Nov]; 5
(2
): 125-130
PMID28508963
show ga
A 36-year-old woman who was undergoing dialysis for end-stage kidney disease
(ESKD) was admitted to our hospital with consciousness disorder. She was
diagnosed with Budd-Chiari syndrome due to antiphospholipid syndrome at the age
of 28 years. Her kidney function and leg edema gradually deteriorated. After
initiation of hemodialysis (HD), transient loss of consciousness due to hepatic
encephalopathy during HD treatment occurred frequently. Her kidney replacement
therapy was changed to online hemodiafiltration (HDF), which dramatically
improved her hepatic coma. Compared with HD, HDF contributed to the increase in
Fischer's ratio and decrease in tryptophan level, which has a high protein-bound
property. This case suggests that HDF may be beneficial for hepatic
encephalopathy in ESKD patients by modulating the amino acid profile.