Hyperammonemic Encephalopathy During Hemodialysis
Authors: VINCENT J. CANZANELLO
Journal: Annals of Internal Medicine (1983)

Brief Reports1 August 1983Hyperammonemic Encephalopathy During HemodialysisVINCENT J. CANZANELLO, M.D., RAYMOND T. RASMUSSEN, B.S., M. DONALD McGOLDRICK, M.B.VINCENT J. CANZANELLO, M.D.Search for more papers by this author, RAYMOND T. RASMUSSEN, B.S.Search for more papers by this author, M. DONALD McGOLDRICK, M.B.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-2-190 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptRenal failure may precipitate or exacerbate hepatic encephalopathy in patients with liver disease (1, 2). One postulated mechanism is the excessive production of ammonia by the bacterial flora of the gastrointestinal tract as a result of high blood urea nitrogen levels. Others (2) postulate that there is underexcretion of potentially toxic, but as yet unidentified, metabolites that accumulate in patients with severe liver disease. Hyperammonemic encephalopathy recently has been described in a patient with normal liver function and excessive ammonia production secondary to infection in a neurogenic bladder (3).Standard hemodialysis (1, 2, 4) and modifications such as the use...References1. PEREZOSTER GJ. A critical review of the role of dialysis in the treatment of liver disease. In: EPSTEIN M, ed. The Kidney in Liver Disease. New York: Elsevier; 1978:325-36. Google Scholar2. OSTERPEREZMATERSONSCHIFFVAAMONDE JGBEC. Exacerbation of hepatic encephalopathy by chronic renal failure: response to maintenance hemodialysis. Clin Nephrol. 1978;9:254-7. MedlineGoogle Scholar3. DRAYNATITCOMBVARMASOERGEL CCRK. Hyperammonemic encephalopathy caused by infection in a neurogenic bladder. N Engl J Med. 1981;304:766-8. CrossrefMedlineGoogle Scholar4. KILEYPENDERWELCHWELCH JJHC. Ammonia intoxication treated by hemodialysis. N Engl J Med. 1958;259:1156-61. CrossrefMedlineGoogle Scholar5. DENISOPOLON JP. Treatment of encephalopathy during fulminant hepatic failure by hemodialysis with high permeability membrane. Gut. 1978;19:787-93. CrossrefMedlineGoogle Scholar6. MERINOJETZERBUSELMEIERNAJARIAN GTTJ. Hemodialysis against activated charcoal suspension as a treatment of hepatic encephalopathy. Trans Am Soc Artif Intern Organs. 1977;23:591-7. CrossrefMedlineGoogle Scholar7. GRIMSONMELLONBRAUDECANALESEWILLIAMS APSJR. Earlier charcoal hemoperfusion in fulminant hepatic failure. Lancet. 1982;2:681-3. CrossrefMedlineGoogle Scholar8. GORDONBETTERGREENBAUMMARANTZGRALMAXWELL AOMLTM. Clinical maintenance hemodialysis with a Sorbentbased low-volume dialysate regeneration system. Trans Am Soc Artif Intern Organs. 1971;17:253-6. MedlineGoogle Scholar9. HOYUMPADESMONDAVANTROBERTSSCHENKER APGRS. Hepatic encephalopathy. Gastroenterology. 1979;76:184-95. CrossrefMedlineGoogle Scholar10. DRUKKERPARSONSGORDON WFA. Practical application of dialysate regeneration: the REDY system. In: DRUKKER W, PARSONS F, MAHER J, eds. Replacement of Renal Function by Dialysis. The Hague: Martinus Nijhoff; 1978:244-58. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Albany Medical College Albany, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDisabling portosystemic encephalopathy in a non-cirrhotic patient: Successful endovascular treatment of a giant inferior mesenteric-caval shunt via the left internal iliac veinPortal‐systemic encephalopathy in non‐cirrhotic patients: Classification of clinical types, diagnosis and treatmentOrnithine Aminotransferase as a Therapeutic Target in HyperammonemiasEndogenous ornithine in search for CNS functions and therapeutic applicationsReferencesHemodialysis, Ammonia, and EncephalopathyMICHAEL J. BLUMENKRANTZ, M.D., SALEH SALEHMOGHADDAN 1 August 1983Volume 99, Issue 2Page: 190-191KeywordsAmmoniaBladderBlood urea nitrogenBrain diseasesGastrointestinal tractLiverLiver diseasesMetabolitesNephrologyRenal failure Issue Published: 1 August 1983 PDF downloadLoading ...