A report of two children cases with hyperammonemia treated with continuous renal replacement therapy

Abstract

We have limited experienced of continuous renal replacement therapy performed in children, in our hospital. Due to differences between children and adults, criteria have yet to be established for indications and settings for acute blood purification. Here we report two cases treated with continuous hemodialysis in children with hyperammonemia. Although we were successful in lowering ammonia levels in both cases, we were unable to save patient 1. Patient 2 recovered and was discharged. Patient 2 was subsequently readmitted with recurrent hyperammonemia associated with infection, and was treated with continuous hemodialysis again. He recovered and was able to undergo a live donor liver transplant. Acute blood purification in cases with metabolic disorders often needs higher blood flow and dialysate flow rates than other cases. More examination of the terms of blood purification induction and settings for therapeutic effect is required to perform the safe and efficacious blood purification for children.