Abstract
We present the case of a 63-year-old woman who was admitted to the intensive care unit for altered mental status and hypotension 3 weeks after creation of an arteriovenous fistula (AVF). She was found to have high-output heart failure and evidence of acute hepatic failure. High-output heart failure is a known complication of AVF creation, but hepatic failure after AVF has not been previously described. We present such a case.