title: Prevention of dialysis disequilibrium by use of CVVH.
abstract: OBJECTIVE
  Dialysis disequilibrium occurs due to a rapid shift of osmols when hemodialysis is used in cases of extreme uremia. Continuous veno-venous hemofiltration (CVVH) with citrate anticoagulation may offer a safe method of urea reduction.
  
  
  METHODS
  Retrospective, clinical observation.
  
  
  METHODS
  Tertiary pediatric intensive care unit and nephrology program. Patients. Two males, ages 10 and 12 years of age.
  
  
  METHODS
  CVVH with citrate anticoagulation.
  
  
  RESULTS
  Three to four day reduction of BUN from 180 mg/dL to 22 mg/dL and from 279 mg/dL to 23 mg/dL.
  
  
  CONCLUSIONS
  Slow and safe improvement of severe urea, hyperphosphatemia, hypocalcemia, and anemia without untoward side effects.
authors.affiliation: Pediatric Nephrology, DeVos Children's Hospital, Grand Rapids, MI 49503, USA. timothy.bunchman@devoschildrens.org
authors.forename: T E
authors.initials: TE
authors.lastname: Bunchman
authors.forename: R M
authors.initials: RM
authors.lastname: Hackbarth
authors.forename: N J
authors.initials: NJ
authors.lastname: Maxvold
authors.forename: J W
authors.initials: JW
authors.lastname: Winters
authors.forename: G-M
authors.initials: GM
authors.lastname: Barletta
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D002951:Citrates / Q000627:therapeutic use; D006440:Hemofiltration; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000628:therapy; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects; D014508:Urea / Q000378:metabolism; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D002951:Citrates; D014508:Urea