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Keywords： amantadine, hypoalbuminemia, blood purification, acute kidney injury, malignant syndrome 〈Abstract〉 Amantadine is widely used to treat Parkinson's disease. However, it should not be used in patients with impaired renal function since it is almost exclusively metabolized through renal excretion. We experienced a rare case of amantadine intoxication in a patient with Parkinson's disease and nephrotic syndrome. A 71-year-old patient initially had normal renal function(eGFR： 62 mL/min/1.73 m 2)and received the optimal dose of amantadine(150 mg/day). The patient then developed new-onset nephrotic syndrome with severe hypoalbuminemia(1.6 g/dL) , which was complicated by an acute kidney injury. This resulted in amantadine intoxication. Treatment with both direct hemoperfusion(DHP)and hemodiafiltration(HDF)effectively reduced the patient's serum amantadine concentration； however, this caused neuroleptic malignant syndrome, which manifested as disturbed con

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