Consensus guidelines for management of hyperammonaemia in paediatric patients receiving continuous kidney replacement therapy.

Consensus guidelines for management of hyperammonaemia in paediatric patients receiving continuous kidney replacement therapy.

Raina Rupesh; Bedoyan Jirair K; Lichter-Konecki Uta; Jouvet Philippe; Picca Stefano; Mew Nicholas Ah; Machado Marcel C; Chakraborty Ronith; Vemuganti Meghana; Grewal Manpreet K; Bunchman Timothy; Sethi Sidharth Kumar; Krishnappa Vinod; McCulloch Mignon; Alhasan Khalid; Bagga Arvind; Basu Rajit K; Schaefer Franz; Filler Guido; Warady Bradley A

Nature reviews. Nephrology

2020

2020-04-08

Hyperammonaemia in children can lead to grave consequences in the form of cerebral oedema, severe neurological impairment and even death. In infants and children, common causes of hyperammonaemia include urea cycle disorders or organic acidaemias. Few studies have assessed the role of extracorporeal therapies in the management of hyperammonaemia in neonates and children. Moreover, consensus guidelines are lacking for the use of non-kidney replacement therapy (NKRT) and kidney replacement therapies (KRTs, including peritoneal dialysis, continuous KRT, haemodialysis and hybrid therapy) to manage hyperammonaemia in neonates and children. Prompt treatment with KRT and/or NKRT, the choice of which depends on the ammonia concentrations and presenting symptoms of the patient, is crucial. This expert Consensus Statement presents recommendations for the management of hyperammonaemia requiring KRT in paediatric populations. Additional studies are required to strengthen these recommendations.

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1759-507X 1759-5061

NEOMED College of Medicine

Department of Internal Medicine

June 2020 Update II

Cleveland Clinic Akron General Hospital