REMOVAL OF AMINO-ACIDS BY CONTINUOUS HEMO FILTRATION AND HEMODIAFILTRATION

Background. - Continuous hemofiltration is potentially more efficient than hemofiltration for removing low molecular metabolites. Case repor t - A newborn (2100 g) was admitted suffering from acute distress with status epilepticus, liver failure with generalized hyperaminoacidemia , hypoglycemia and oligo-anuria. Peritoneal dialysis, performed on the 17(th) day of life, was ineffective and the patient was treated by co ntinuous hemofiltration alterning with hemodiafiltration. Clearance of amino-acids was studied for 15 minutes under each technique. The ar n ino-acid concentrations were measured in the infused fluid and in the ultrafiltrate. The baby died on the 20(th) day despite this treatment. Results. - Aminoacid clearance by hemodiafiltration was 181 +/- 176% greater than by hemofiltration. The mean improvement for all aminoacid s was 148%, with extremes of + 43% for citrulline and 941% for glutami c acid. Conclusion. - Continuous hemodialfiltration is an efficient me thod of removing aminoacids; it could be used to treat severe inborn e rrors of metabolism such as leucinosis.