Abstract
We report a 60-year old male hemodialysis patient with intermittent deep coma due to liver cirrhosis. The patient had a clinical history of hemodialysis (HD) due to hepatonephric syndrome resulting from chronic hepatitis C and alcoholic cirrhosis for 5 years. Serum ammonia level gradually increased, despite the alteration from HD to hemodiafiltration (HDF) and administration of lactulose orally and Aminoleban™ intravenously. The rate of ablation in serum ammonia was about 30% and satisfactory. However, the patient was admitted to the hospital 6 times in 8 months for deep coma and died due to respiratory disturbance at home. Advanced alkalosis was more closely correlated with the onset of deep coma than was ammonia level in this case.
