A biphasic dialytic strategy for the treatment of neonatal hyperammonemia

Hanudel, Mark R.; Avasare, Sonal; Tsai, Ethan; Yadin, Ora; Zaritsky, Joshua J.

doi:10.1007/s00467-013-2638-x

Cited by 23 publications

(21 citation statements)

References 15 publications

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“…This high dose CKRT resulted in clearance rates (that is, total replacement and/or Qd) of up to 8,000 ml/1.73 m 2 /h or more and was safe for the patients 34 . In other studies, Qb 10-20 ml/min in neonates and infants has achieved clearance rates (total replacement and/or Qd) of ≥2,500 ml/1.73 m 2 /h 41,43 . However, not all CKRT machines can achieve an opti mal Qd value.…”

Section: Box 3 | Recommendations From the Consensus Panel For Pdmentioning

confidence: 80%

Consensus guidelines for management of hyperammonaemia in paediatric patients receiving continuous kidney replacement therapy

et al. 2020

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Hyperammonaemia in children can lead to grave consequences in the form of cerebral oedema, severe neurological impairment and even death. In infants and children, common causes of hyperammonaemia include urea cycle disorders or organic acidaemias. Few studies have assessed the role of extracorporeal therapies in the management of hyperammonaemia in neonates and children. Moreover, consensus guidelines are lacking for the use of non-kidney replacement therapy (NKRT) and kidney replacement therapies (KRTs, including peritoneal dialysis, continuous KRT, haemodialysis and hybrid therapy) to manage hyperammonaemia in neonates and children. Prompt treatment with KRT and/or NKRT, the choice of which depends on the ammonia concentrations and presenting symptoms of the patient, is crucial. This expert Consensus Statement presents recommendations for the management of hyperammonaemia requiring KRT in paediatric populations. Additional studies are required to strengthen these recommendations.

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Section: Box 3 | Recommendations From the Consensus Panel For Pdmentioning

confidence: 80%

Consensus guidelines for management of hyperammonaemia in paediatric patients receiving continuous kidney replacement therapy

et al. 2020

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“…Therefore, CRRT including continuous venovenous hemofiltration or continuous venovenous hemodiafiltration is the preferred method. 17 , 18 , 52 It is very important to emphasize that at this stage, fast action is required to prevent brain injury; therefore, the line for dialysis should be inserted immediately. Every place should develop its own protocol for who should insert the dialysis line depending on the local resources.…”

Section: Resultsmentioning

confidence: 99%

Guidelines for acute management of hyperammonemia in the Middle East region

Alfadhel¹,

Mutairi²,

Makhseed³

et al. 2016

TCRM

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BackgroundHyperammonemia is a life-threatening event that can occur at any age. If treated, the early symptoms in all age groups could be reversible. If untreated, hyperammonemia could be toxic and cause irreversible brain damage to the developing brain.ObjectiveThere are major challenges that worsen the outcome of hyperammonemic individuals in the Middle East. These include: lack of awareness among emergency department physicians about proper management of hyperammonemia, strained communication between physicians at primary, secondary, and tertiary hospitals, and shortage of the medications used in the acute management of hyperammonemia. Therefore, the urge to develop regional guidelines is extremely obvious.MethodWe searched PubMed and Embase databases to include published materials from 2011 to 2014 that were not covered by the European guidelines, which was published in 2012. We followed the process of a Delphi conference and involved one preliminary meeting and two follow-up meetings with email exchanges between the Middle East Hyperammonemia and Urea Cycle Disorders Scientific Group regarding each draft of the manuscript.Results and discussionWe have developed consensus guidelines based on the highest available level of evidence. The aim of these guidelines is to homogenize and harmonize the treatment protocols used for patients with acute hyperammonemia, and to provide a resource to not only metabolic physicians, but also physicians who may come in contact with individuals with acute hyperammonemia.ConclusionThese suggested guidelines aim to ease the challenges faced by physicians dealing with acute hyperammonemia in the region. In addition, guidelines have demonstrated useful collaboration between experts in the region, and provides information that will hopefully improve the outcomes of patients with acute hyperammonemia.

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“…However, in small case series, high-dose CRRT has been shown to be efficacious for the acute management of severe hyperammonemia (> 400 mmol/L) in infants with inborn errors of metabolism. 40,41 The role of CRRT in adults with hyperammonemia complicating liver failure is less certain. CRRT is associated with reductions in plasma ammonia levels.…”

Section: Drug and Toxin Removalmentioning

confidence: 99%

Continuous Renal Replacement Therapy

Tandukar

Palevsky

2019

Chest

233

252

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Continuous renal replacement therapy (CRRT) is commonly used to provide renal support for critically ill patients with acute kidney injury, particularly patients who are hemodynamically unstable. A variety of techniques that differ in their mode of solute clearance may be used, including continuous venovenous hemofiltration with predominantly convective solute clearance, continuous venovenous hemodialysis with predominantly diffusive solute clearance, and continuous venovenous hemodiafiltration, which combines both dialysis and hemofiltration. The present article compares CRRT with other modalities of renal support and reviews indications for initiation of renal replacement therapy, as well as dosing and technical aspects in the management of CRRT.

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A biphasic dialytic strategy for the treatment of neonatal hyperammonemia

Cited by 23 publications

References 15 publications

Consensus guidelines for management of hyperammonaemia in paediatric patients receiving continuous kidney replacement therapy

Consensus guidelines for management of hyperammonaemia in paediatric patients receiving continuous kidney replacement therapy

Guidelines for acute management of hyperammonemia in the Middle East region

Continuous Renal Replacement Therapy

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