Dehydration from diuretic therapy and diarrhea, infection, some medications, and progression of liver disease can all lead
to kidney failure, which
in turn leads
to decreased clearance of urea,
ammonia, and other toxins that can contribute to encephalopathy.
• Other factors: A rise of blood pH (alkalosis), which often results from diuretics and resulting dehydration, may facilitate entry of ammonia into the brain and exacerbate encephalopathy.