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Course of encephalopathy in a cirrhotic dialysis patient treated sequentially with peritoneal and hemodialysis.

Koz S, Sahin I, Terzi Z, Koz ST - Case Rep Med (2015)

Bottom Line: There is no consensus on dialysis modality in terms of determining the optimal way of treating these patients.We report a case with advanced cirrhosis and end-stage kidney disease who was faced with hepatic encephalopathy episodes up on starting renal replacement therapy.The case is also interesting in that it reveals effects of hemodialysis and peritoneal dialysis on hepatic encephalopathy episodes and quality of life of the patient.

View Article: PubMed Central - PubMed

Affiliation: Nephrology Clinic, Malatya State Hospital, 44100 Malatya, Turkey.

ABSTRACT
End-stage kidney disease and advanced cirrhosis are sometimes seen concomitantly. There is no consensus on dialysis modality in terms of determining the optimal way of treating these patients. It has been suggested that peritoneal dialysis is a better choice for these patients, but efficacy of hemodialysis in stable cirrhotic patients has not been evaluated sufficiently. We report a case with advanced cirrhosis and end-stage kidney disease who was faced with hepatic encephalopathy episodes up on starting renal replacement therapy. The case is also interesting in that it reveals effects of hemodialysis and peritoneal dialysis on hepatic encephalopathy episodes and quality of life of the patient.

No MeSH data available.


Related in: MedlinePlus

Mean Na, K, and albumin levels of the patient during PreD, PD and HD periods. The numbers on the graph lines represent the means. *Na: Na level of PD is significantly lower than that of PreD, P = 0.004. Differences between other groups are not significant. **K: K level of PD is significantly lower than that of PreD P = 0.006, and K level of HD is significantly lower than that of PreD P = 0.01. The difference between mean K level of PD and HD periods is not significant. ***Albumin: differences between groups are not statistically significant. n: number of laboratory values in the relevant period, PreD: predialysis period, PD: peritoneal dialysis period, and HD: hemodialysis period. Comparisons between groups were done by using Wilcoxon Signed Rank Test (Statistical Package designed for the Social Sciences (SPSS) software, version 17.0 (SPSS Inc., Chicago, IL, USA)), and P < 0.05 was considered as statistically significant.
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fig1: Mean Na, K, and albumin levels of the patient during PreD, PD and HD periods. The numbers on the graph lines represent the means. *Na: Na level of PD is significantly lower than that of PreD, P = 0.004. Differences between other groups are not significant. **K: K level of PD is significantly lower than that of PreD P = 0.006, and K level of HD is significantly lower than that of PreD P = 0.01. The difference between mean K level of PD and HD periods is not significant. ***Albumin: differences between groups are not statistically significant. n: number of laboratory values in the relevant period, PreD: predialysis period, PD: peritoneal dialysis period, and HD: hemodialysis period. Comparisons between groups were done by using Wilcoxon Signed Rank Test (Statistical Package designed for the Social Sciences (SPSS) software, version 17.0 (SPSS Inc., Chicago, IL, USA)), and P < 0.05 was considered as statistically significant.

Mentions: Figure 1 summarizes data concerning serum Na, K, and albumin levels of the patient during the different periods of follow-up. The data were obtained, retrospectively, from electronic database of the hospital; all of the values present in the database were included in the analysis. In brief, mean Na and K levels were significantly lower during PD compared to predialysis (PreD) period. Six of the 13 Na measurements during the PD period were equal to or lower than 130 mmol/L. Analysis revealed no statistically significant differences between PD and HD in terms of mean Na, K, and albumin levels. Mean ammonia levels during PD and HD were 182.6 and 184.6 mg/dL, respectively. Mean blood urea nitrogen (BUN) levels during PD and HD periods were 96.5 ± 17.2 and 49.8 ± 27.5 (P < 0.05, Mann-Whitney U Test). Mean creatinine levels during PD and HD periods were 6.9 ± 1.4 and 4.7 ± 0.7 (P < 0.05, Mann-Whitney U Test).


Course of encephalopathy in a cirrhotic dialysis patient treated sequentially with peritoneal and hemodialysis.

Koz S, Sahin I, Terzi Z, Koz ST - Case Rep Med (2015)

Mean Na, K, and albumin levels of the patient during PreD, PD and HD periods. The numbers on the graph lines represent the means. *Na: Na level of PD is significantly lower than that of PreD, P = 0.004. Differences between other groups are not significant. **K: K level of PD is significantly lower than that of PreD P = 0.006, and K level of HD is significantly lower than that of PreD P = 0.01. The difference between mean K level of PD and HD periods is not significant. ***Albumin: differences between groups are not statistically significant. n: number of laboratory values in the relevant period, PreD: predialysis period, PD: peritoneal dialysis period, and HD: hemodialysis period. Comparisons between groups were done by using Wilcoxon Signed Rank Test (Statistical Package designed for the Social Sciences (SPSS) software, version 17.0 (SPSS Inc., Chicago, IL, USA)), and P < 0.05 was considered as statistically significant.
© Copyright Policy - open-access
Related In: Results  -  Collection

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fig1: Mean Na, K, and albumin levels of the patient during PreD, PD and HD periods. The numbers on the graph lines represent the means. *Na: Na level of PD is significantly lower than that of PreD, P = 0.004. Differences between other groups are not significant. **K: K level of PD is significantly lower than that of PreD P = 0.006, and K level of HD is significantly lower than that of PreD P = 0.01. The difference between mean K level of PD and HD periods is not significant. ***Albumin: differences between groups are not statistically significant. n: number of laboratory values in the relevant period, PreD: predialysis period, PD: peritoneal dialysis period, and HD: hemodialysis period. Comparisons between groups were done by using Wilcoxon Signed Rank Test (Statistical Package designed for the Social Sciences (SPSS) software, version 17.0 (SPSS Inc., Chicago, IL, USA)), and P < 0.05 was considered as statistically significant.
Mentions: Figure 1 summarizes data concerning serum Na, K, and albumin levels of the patient during the different periods of follow-up. The data were obtained, retrospectively, from electronic database of the hospital; all of the values present in the database were included in the analysis. In brief, mean Na and K levels were significantly lower during PD compared to predialysis (PreD) period. Six of the 13 Na measurements during the PD period were equal to or lower than 130 mmol/L. Analysis revealed no statistically significant differences between PD and HD in terms of mean Na, K, and albumin levels. Mean ammonia levels during PD and HD were 182.6 and 184.6 mg/dL, respectively. Mean blood urea nitrogen (BUN) levels during PD and HD periods were 96.5 ± 17.2 and 49.8 ± 27.5 (P < 0.05, Mann-Whitney U Test). Mean creatinine levels during PD and HD periods were 6.9 ± 1.4 and 4.7 ± 0.7 (P < 0.05, Mann-Whitney U Test).

Bottom Line: There is no consensus on dialysis modality in terms of determining the optimal way of treating these patients.We report a case with advanced cirrhosis and end-stage kidney disease who was faced with hepatic encephalopathy episodes up on starting renal replacement therapy.The case is also interesting in that it reveals effects of hemodialysis and peritoneal dialysis on hepatic encephalopathy episodes and quality of life of the patient.

View Article: PubMed Central - PubMed

Affiliation: Nephrology Clinic, Malatya State Hospital, 44100 Malatya, Turkey.

ABSTRACT
End-stage kidney disease and advanced cirrhosis are sometimes seen concomitantly. There is no consensus on dialysis modality in terms of determining the optimal way of treating these patients. It has been suggested that peritoneal dialysis is a better choice for these patients, but efficacy of hemodialysis in stable cirrhotic patients has not been evaluated sufficiently. We report a case with advanced cirrhosis and end-stage kidney disease who was faced with hepatic encephalopathy episodes up on starting renal replacement therapy. The case is also interesting in that it reveals effects of hemodialysis and peritoneal dialysis on hepatic encephalopathy episodes and quality of life of the patient.

No MeSH data available.


Related in: MedlinePlus