Exercise-Induced Hyperammonemia Does Not Precipitate Overt Hepatic Encephalopathy.

Moderate-to-vigorous exercise increases blood ammonia concentrations, potentially contributing to the development of hepatic encephalopathy (HE). Patients with end-stage liver disease (ESLD) often suffer from frailty or physical deconditioning as a result of sarcopenia, fluid overload/ascites, obesity and concomitant diseases. Exercise is therefore recommended for ESLD patients to reverse or halt progression of frailty/sarcopenia, as these conditions contribute to increased mortality.