Renal Disease

Ascites and chronic encephalopathy are common com-plications among patients with liver cirrhosis, for which abdominal paracenteses and lactulose use represent the standard therapeutic options. However, more-aggressive interventions to normalize blood ammonia and prevent irreversible neuronal damage are required in some cases. Traditional hemodialysis is an efficient method for removing serum ammonia, but the related risks of bleed-ing and hypotension limit its use in cirrhotic patients (1). Here, we report the case of such a patient, in whom the underlying chronic kidney disease did not require renal replacement therapy, but in whom severe recurrent encephalopathy and refractory ascites were successfully treated with continuous ambulatory peritoneal dialysis (CAPD) at home for 10 months