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Clin J Am Soc Nephrol. 2016 Oct 7;11(10):1872-1878. doi: 10.2215/CJN.01320216. Epub 2016 May 19.

The Role of RRT in Hyperammonemic Patients.

Author information

1
Department of Internal Medicine and sgupta21@partners.org.
2
Renal Division, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
3
ESRD Consulting, PLLC, Austin, Texas; and.
4
Department of Medicine, University of Texas Southwestern, Dallas, Texas.

Abstract

Hyperammonemia is an important cause of cerebral edema in both adults with liver failure and children with inborn errors of metabolism. There are few studies that have analyzed the role of extracorporeal dialysis in reducing blood ammonia levels in the adult population. Furthermore, there are no firm guidelines about when to implement RRT, because many of the conditions that are characterized by hyperammonemia are extremely rare. In this review of existing literature on RRT, we present the body's own mechanisms for clearing ammonia as well as the dialytic properties of ammonia. We review the available literature on the use of continuous venovenous hemofiltration, peritoneal dialysis, and hemodialysis in neonates and adults with conditions characterized by hyperammonemia and discuss some of the controversies that exist over selecting one modality over another.

KEYWORDS:

Ammonia; Hemofiltration; Humans; Hyperammonemia; Renal Replacement Therapy; electrolytes; liver failure; outcomes; peritoneal dialysis; renal dialysis

PMID:
27197910
PMCID:
PMC5053785
DOI:
10.2215/CJN.01320216
[Indexed for MEDLINE]
Free PMC Article

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