THE ADDITION OF AMINO-ACIDS AND PHOSPHATE TO HEMODIAFILTRATION SOLUTIONS IN NEWBORNS WITH HYPERAMMONEMIC COMA

A child with carbamyl-phosphate-synthetase defect who died after prolo nged continuous hemodiafiltration in deep coma proved to have high ami noacid losses despite aminoacid infusion. We think that this results f rom high small-solute clearance during hemodialysis. In order to preve nt these unevitable catabolic side-effects we decided to add aminoacid s to the dialysate and substitution fluid in these children with metab olic diseases. Additionally we propose to add phosphate in order to av oid depletion. The aim is to achieve anabolic or at least non-cataboli c hemodiafiltration.