Ammonia clearance by peritoneal dialysis and continuous arteriovenous hemodiafiltration.
We report the use of continuous arteriovenous hemodiafiltration (CAVHD) in a neonate with severe hyperammonemia due to a urea cycle disorder. We compared the ammonia clearance (C(NH3)) for peritoneal dialysis (PD) and CAVHD. C(NH3) for CAVHD was 7.45 ml/min per m2 at a dialysate flow of 300 ml/h and was 10.55 ml/min per m2 at a dialysate flow rate of 600 ml/h. The mean PD clearance was 2.15 ml/min per m2. Our data suggest that CAVHD is superior to PD for the removal of plasma ammonia. We conclude that CAVHD should be considered a reasonable alternative in the treatment of neonatal hyperammonemia in urea cycle disorders when medical treatment fails.
Wong
K Y
KY
Department of Pediatrics, Queen Mary Hospital, Hong Kong.
Wong
S N
SN
Lam
S Y
SY
Tam
S
S
Tsoi
N S
NS
D000641:Ammonia / Q000097:blood / Q000378:metabolism* / Q000652:urine; D017809:Fatal Outcome; D006440:Hemofiltration; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008661:Metabolism, Inborn Errors / Q000378:metabolism / Q000628:therapy; D010531:Peritoneal Dialysis, Continuous Ambulatory; D012079:Renal Circulation / Q000502:physiology; D051437:Renal Insufficiency / Q000378:metabolism / Q000628:therapy; D014508:Urea / Q000378:metabolism
D000641:Ammonia; D014508:Urea