Transjugular Intrahepatic Portosystemic Shunts in Hemodialysis-dependent Patients and Patients with Advanced Renal Insufficiency: Safety, Caution, and Encephalopathy

TIPS creation is effective in controlling ascites and bleeding in functionally anephric patients, but at the cost of marked and disproportionate hepatic encephalopathy. Prompt, acute postprocedural dialysis and fluid management is critical for safe creation of a TIPS in dialysis-dependent patients.