Wong K Y, Wong S N, Lam S Y, Tam S, Tsoi N S
Department of Pediatrics, Queen Mary Hospital, Hong Kong.
Pediatr Nephrol. 1998 Sep;12(7):589-91. doi: 10.1007/s004670050511.
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.
我们报告了在一名因尿素循环障碍导致严重高氨血症的新生儿中使用持续动静脉血液透析滤过（CAVHD）的情况。我们比较了腹膜透析（PD）和CAVHD的氨清除率（C(NH3)）。在透析液流速为300 ml/h时，CAVHD的C(NH3)为7.45 ml/min per m2，在透析液流速为600 ml/h时为10.55 ml/min per m2。PD的平均清除率为2.15 ml/min per m2。我们的数据表明，在清除血浆氨方面，CAVHD优于PD。我们得出结论，当药物治疗失败时，CAVHD应被视为治疗尿素循环障碍新生儿高氨血症的合理替代方法。
