Ammonia clearance by peritoneal dialysis and continuous arteriovenous hemodiafiltration

Pediatr Nephrol. 1998 Sep;12(7):589-91. doi: 10.1007/s004670050511.


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 (PD) and CAVHD. C(NH3) for CAVHD was 7.45 ml/min per m2 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 m2. 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 when medical treatment fails.

Publication types

  • Case Reports

MeSH terms

  • Ammonia / blood
  • Ammonia / metabolism*
  • Ammonia / urine
  • Fatal Outcome
  • Hemofiltration*
  • Humans
  • Infant, Newborn
  • Male
  • Metabolism, Inborn Errors / metabolism
  • Metabolism, Inborn Errors / therapy
  • Peritoneal Dialysis, Continuous Ambulatory*
  • Renal Circulation / physiology
  • Renal Insufficiency / metabolism
  • Renal Insufficiency / therapy
  • Urea / metabolism


  • Ammonia
  • Urea