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Hemodiafiltration for hepatic encephalopathy induced by Budd-Chiari syndrome in a patient with end-stage kidney disease.血液透析滤过治疗终末期肾病患者布加综合征所致肝性脑病
CEN Case Rep. 2016 Nov;5(2):125-130. doi: 10.1007/s13730-015-0209-7. Epub 2015 Dec 11.
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Favourable medium term outcome following hepatic vein recanalisation and/or transjugular intrahepatic portosystemic shunt for Budd Chiari syndrome.布加综合征肝静脉再通和/或经颈静脉肝内门体分流术后的中期良好预后
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本文引用的文献

1
Budd-Chiari syndrome: a single-center experience.布加综合征：单中心经验
World J Gastroenterol. 2014 Nov 21;20(43):16236-44. doi: 10.3748/wjg.v20.i43.16236.
2
Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver.慢性肝病中的肝性脑病：美国肝病研究协会和欧洲肝脏研究协会2014年实践指南
Hepatology. 2014 Aug;60(2):715-35. doi: 10.1002/hep.27210. Epub 2014 Jul 8.
3
How to prescribe hemodialysis or hemodiafiltration in order to ameliorate dialysis-related symptoms and complications.如何开具血液透析或血液滤过处方以改善透析相关症状和并发症。
Contrib Nephrol. 2011;168:53-63. doi: 10.1159/000321744. Epub 2010 Oct 7.
4
Hepatic encephalopathy as a complication of liver cirrhosis: an Asian perspective.肝性脑病作为肝硬化的并发症：亚洲视角。
J Gastroenterol Hepatol. 2010 May;25(5):858-63. doi: 10.1111/j.1440-1746.2010.06242.x.
5
Renal involvement in primary antiphospholipid syndrome: retrospective analysis of 160 patients.原发性抗磷脂综合征的肾脏受累：160 例患者的回顾性分析。
Clin J Am Soc Nephrol. 2010 Jul;5(7):1211-7. doi: 10.2215/CJN.00460110. Epub 2010 Apr 29.
6
Hepatic encephalopathy.肝性脑病
Med Clin North Am. 2008 Jul;92(4):795-812, viii. doi: 10.1016/j.mcna.2008.03.009.
7
Role of tryptophan in the pathogenesis of hepatic encephalopathy.色氨酸在肝性脑病发病机制中的作用。
J Pak Med Assoc. 2008 Feb;58(2):68-70.
8
Push/pull hemodiafiltration.推挽式血液透析滤过
Contrib Nephrol. 2007;158:169-176. doi: 10.1159/000107247.
9
Portosystemic encephalopathy in a patient treated with peritoneal dialysis.一名接受腹膜透析治疗的患者出现门体分流性脑病。
Am J Kidney Dis. 2007 Jun;49(6):854-8. doi: 10.1053/j.ajkd.2007.03.001.
10
Neostigmine for the treatment of acute hepatic encephalopathy with acute intestinal pseudo-obstruction in a cirrhotic patient.新斯的明用于治疗一名肝硬化患者急性肝性脑病合并急性假性肠梗阻。
J Korean Med Sci. 2005 Feb;20(1):150-2. doi: 10.3346/jkms.2005.20.1.150.

血液透析滤过治疗终末期肾病患者布加综合征所致肝性脑病

Hemodiafiltration for hepatic encephalopathy induced by Budd-Chiari syndrome in a patient with end-stage kidney disease.

作者信息

Wakamatsu Takuya, Yamamoto Suguru, Kamimura Kenya, Nakatsue Takeshi, Iino Noriaki, Iguchi Seitaro, Kaneko Yoshikatsu, Goto Shin, Kazama Junichiro James, Narita Ichiei

机构信息

Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan.

Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

出版信息

CEN Case Rep. 2016 Nov;5(2):125-130. doi: 10.1007/s13730-015-0209-7. Epub 2015 Dec 11.

DOI:10.1007/s13730-015-0209-7
PMID:28508963
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5413750/
Abstract

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.

摘要

一名因终末期肾病（ESKD）正在接受透析的36岁女性因意识障碍入住我院。她在28岁时被诊断为抗磷脂综合征所致的布加综合征。她的肾功能和腿部水肿逐渐恶化。开始血液透析（HD）后，HD治疗期间频繁发生因肝性脑病导致的短暂意识丧失。她的肾脏替代治疗改为在线血液透析滤过（HDF），这显著改善了她的肝昏迷。与HD相比，HDF有助于提高费舍尔比值并降低具有高蛋白结合特性的色氨酸水平。该病例表明，HDF可能通过调节氨基酸谱对ESKD患者的肝性脑病有益。