[Removal of amino acids by continuous hemofiltration and hemodiafiltration].
BACKGROUND
Continuous hemodiafiltration is potentially more efficient than hemofiltration for removing low molecular metabolites.


METHODS
A newborn (2100 g) was admitted suffering from acute distress with statuts epilepticus, liver failure with generalized hyperaminoacidemia, hypoglycemia and oligo-anuria. Peritoneal dialysis, performed on the 17th day of life, was ineffective and the patient was treated by continuous hemofiltration alternating with hemodiafiltration. Clearance of amino-acids was studied for 15 minutes under each technique. The amino-acid concentrations were measured in the infused fluid and in the ultrafiltrate. The baby died on the 20th day despite this treatment.


RESULTS
Amino acid clearance by hemodiafiltration was 181 +/- 176% greater than by hemofiltration. The mean improvement for all amino acids was 148%, with extremes of +43% for citrulline and 941% for glutamic acid.


CONCLUSIONS
Continuous hemodiafiltration is an efficient method of removing amino acids; it could be used to treat severe inborn errors of metabolism such as leucinosis.
Service de pédiatrie 2, hôpital d'Enfants, Dijon, France.
J B
JB
Gouyon
M
M
Françoise
J
J
Desgres
A M
AM
Petion
D
D
Sandre
D058186:Acute Kidney Injury / Q000628:therapy; D000596:Amino Acids / Q000097:blood / Q000302:isolation & purification*; D017583:Hemodiafiltration / Q000379:methods; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D008297:Male
D000596:Amino Acids
Epuration des acides aminés par hémofiltration et hémodiafiltration continues.