Preventive measures for recurrent hepatic encephalopathy in a hemodialysis patient
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- Nishikawa Mana
- Department of Nephrology, Kurashiki Central Hospital
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- Shimada Noriaki
- Department of Nephrology, Kurashiki Central Hospital
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- Nagayama Izumi
- Department of Nephrology, Kurashiki Central Hospital
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- Fukushima Kazuhiko
- Department of Nephrology, Kurashiki Central Hospital
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- Amano Taeko
- Department of Nephrology, Kurashiki Central Hospital
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- Kawakita Chieko
- Department of Nephrology, Kurashiki Central Hospital
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- Sawada Mariko
- Department of Pediatrics, Kurashiki Central Hospital
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- Kinomura Masaru
- Department of Nephrology, Kurashiki Central Hospital
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- Fukushima Masaki
- Department of Internal Medicine, Shigei Research Institute Hospital
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- Asano Kenichiro
- Department of Nephrology, Kurashiki Central Hospital
Bibliographic Information
- Other Title
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- 血液濾過透析を含めた集学的治療により肝性脳症が管理できた維持血液透析患者の1例
- 症例報告 血液濾過透析を含めた集学的治療により肝性脳症が管理できた維持血液透析患者の1例
- ショウレイ ホウコク ケツエキ ロカ トウセキ オ フクメタ シュウガクテキ チリョウ ニ ヨリ カンセイ ノウショウ ガ カンリ デキタ イジ ケツエキ トウセキ カンジャ ノ 1レイ
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Abstract
A 57-year-old male, who had undergone maintenance hemodialysis (HD) for 35 years, suffered from a long period of HCV infection. He was treated with branched-chain amino acids, levocarnitine and lactulose syrup, and the concentration of bicarbonate in the dialysate was changed from 30 mEq/L to 25 mEq/L to prevent alkalemia. However, he developed repeated hepatic encephalopathy after HD. His liver was cirrhotic and multiple portal-systemic shunts were demonstrated by three-dimensional CT. When measured by color Doppler ultrasonography, the blood flow in the portal vein was decreased after HD. This decrease occurred because of direct flow into the systemic circulation through portal-systemic shunts due to a decrease in the intravenous pressure after HD. After the blood purification modality had been altered to hemodiafiltration (HDF) , the decrease in the portal blood flow was improved. The recurrent hepatic encephalopathy disappeared after the addition of aminoglycoside antibiotics and after the modality of blood purification therapy had been modified. On the basis of this experience, we discuss comprehensive measures to prevent hepatic encephalopathy in hemodialysis patients.
Journal
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- Nihon Toseki Igakkai Zasshi
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Nihon Toseki Igakkai Zasshi 48 (3), 199-205, 2015
The Japanese Society for Dialysis Therapy
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Keywords
Details 詳細情報について
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- CRID
- 1390282679657363840
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- NII Article ID
- 130005130048
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- NII Book ID
- AN10432053
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- ISSN
- 1883082X
- 13403451
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- NDL BIB ID
- 026302309
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed