Discussion: I am not focused and have a hard time driving; I have chronic fatigue. I was told to ask the doctor and check if I do not have liver encephalopathy?

The liver and kidneys work in sync in various metabolic activities. Patients with chronic kidney disease burden their liver, compensating for poor kidney functions. Hepatic encephalopathy is when a high level of ammonia in the blood (a breakdown product of any protein) penetrates through the brain's barriers and causes side effects that affect alertness and cognitive ability. Ammonia is a potent toxin that the liver should eliminate after synthesis and excrete through the kidneys. High ammonia levels in the blood and hepatic encephalopathy may indicate liver failure and require a comprehensive liver function examination.