{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T02:40:46Z","timestamp":1774665646998,"version":"3.50.1"},"reference-count":9,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2013,4,6]],"date-time":"2013-04-06T00:00:00Z","timestamp":1365206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"},{"start":{"date-parts":[[2013,4,6]],"date-time":"2013-04-06T00:00:00Z","timestamp":1365206400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Nephrol Dial"],"abstract":"<jats:p>We report a case of chronic portal-systemic shunt encephalopathy in a 79-year-old female hemodialysis patient with end-stage renal disease. Approximately 1 month before admission, she occasionally had a discrepant conversation. It was considered that hepatic encephalopathy was caused by an increase in the ammonia level in the blood flow of the shunt, which had been diagnosed 7 years previously between the splenic vein and the left renal vein. On admission, disturbed consciousness and an elevated serum ammonia level (221 \u03bcg\/dl) were observed. No change in the shunt diameter was noted. Consciousness improved with conservative treatment, whereas hyperammonemia remained. Balloon-occluded retrograde transvenous obliteration (B-RTO) was performed on the shunt. As a result, hyperammonemia resolved immediately, and the level of ammonia was maintained at approximately 60 \u03bcg\/dl. The patient often complained of drug-induced constipation; therefore, an increase in the intra-abdominal pressure in addition to ammonia production in the intestinal tract was suspected as the cause of encephalopathy. More than 23 months have passed since the B-RTO therapy, and no symptoms of encephalopathy have been observed yet.<\/jats:p>","DOI":"10.1159\/000350908","type":"journal-article","created":{"date-parts":[[2013,4,9]],"date-time":"2013-04-09T08:32:19Z","timestamp":1365496339000},"page":"28-33","source":"Crossref","is-referenced-by-count":8,"title":["Chronic Portal-SystemicShunt Encephalopathy in a Hemodialysis Patient Treated with Balloon-Occluded Retrograde Transvenous Obliteration"],"prefix":"10.1159","volume":"3","author":[{"given":"Ryota","family":"Yasukawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumihiro","family":"Akiyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Tsukishiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichiei","family":"Narita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2013,4,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9270(97)00062-2"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2004.05.035"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1951.03810080005002"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197601000-00005"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.36.886"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.3.5874.279"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2011.08.019"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/nau.10066"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2007.03.001"}],"container-title":["Case Reports in Nephrology and Dialysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/350908","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/350908","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T18:22:01Z","timestamp":1745432521000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000350908"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4,6]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2013,6,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000350908","archive":["Portico"],"relation":{},"ISSN":["2296-9705"],"issn-type":[{"value":"2296-9705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,4,6]]}}}