Successful treatment with hemodiafiltration for a chronic renal failure patient with hyperchioremic metabolic acidosis associated with hepatic coma

Abstract

The effect of hemodiafiltration (HDF) was evaluated in a 64-year-old woman with chronic renal failure who developed hyperchloremic metabolic acidosis associated with hepatic coma. She was admitted t our unit in November 2002 because of hepatic coma. Even treatment with parenteral formulas high in branched-chain amino acids and low in aromatic amino acids had no apparent effect on the coma. Therefore, due to advanced state of hyperchloremic metabolic acidosis, we decided to initiate HDF. Soon after the start of HDF, consciousness and metabolic acidosis recovered.
Our experience suggests that HDF is a useful tool for treatment of severe metabolic acidosis with hepatic coma in cases of renal failure in which conservative therapy such as drug administration has failed.