AUTHOR=Markham Christopher , Williams Caroline , Miller Cory , Grange Dorothy K. , Davis T. Keefe , Remy Kenneth E. 

TITLE=Continuous Renal Replacement Therapy for Two Neonates With Hyperammonemia

JOURNAL=Frontiers in Pediatrics

VOLUME=9

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.732354

DOI=10.3389/fped.2021.732354

ISSN=2296-2360

ABSTRACT=<p><bold>Objectives:</bold> This study aims to assess the feasibility of using hemofiltration for ammonia clearance in low body weight infants with an inborn error of metabolism.</p><p><bold>Design:</bold> A study of two cases.</p><p><bold>Setting:</bold> Quaternary pediatric hospital (Saint Louis Children's Hospital) NICU and PICU.</p><p><bold>Patients:</bold> Infants &lt;6 months of age with an ICD-9 diagnosis of 270.6 (hyperammonemia).</p><p><bold>Interventions:</bold> Continuous renal replacement therapy (CRRT).</p><p><bold>Measurements and Main Results:</bold> We measure serum ammonia levels over time and the rate of ammonia clearance over time. Continuous renal replacement therapy was more effective than scavenger therapy alone (Ammonul™) for rapid removal of ammonia in low weight infants (as low as 2.5 kg).</p><p><bold>Conclusions:</bold> Continuous renal replacement therapy is technically feasible in low weight infants with severe hyperammonemia secondary to an inborn error of metabolism.</p>