AMMONIA CLEARANCE BY PERITONEAL-DIALYSIS AND CONTINUOUS ARTERIOVENOUSHEMODIAFILTRATION

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 (P D) and CAVHD, C-NH3 for CAVHD was 7.45 ml/min per m(2) 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 m(2). 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 w hen medical treatment fails.