Work

Hemodialysis-Related Portal-Systemic Encephalopathy Possibly Associated with Right Femoral Vein Thrombosis

Year: 2024

Type: article

Abstract: In hemodialysis-related portal systemic encephalopathy (HRPSE), transient negative pressure in the inferior vena cava (IVC) during dialysis increases the blood flow through a portal-systemic shunt, leading to encephalopathy. We report the case of a 74-year-old man with a gastrorenal shunt who developed HRPSE for the first time following venous occlusion due to thrombosis around a right femoral tunneled-cuffed hemodialysis catheter. Before the thrombosis dissolved, ammonia levels increased after dialysis. Conversely, after the thrombosis was dissolved, the ammonia levels decreased after dialysis. We hypothesized that venous stasis in the right lower limb due to thrombosis intensified the negative pressure in the IVC during dialysis, triggering HRPSE.

Source: Internal Medicine

DOI: 10.2169/internalmedicine.4621-24

Authors: Kiryu Yoshida, Yuki Mimura, Takumi Fukazawa, Mizuki Sano, Hirohito Sugawara, Hidetoshi Ito

Institution: SHOWA Medical University Northern Yokohama Hospital

Language: English

Topic: Liver Disease and Transplantation

Subfield: Hepatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4405536617