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Peritoneal Dialysis in the Treatment of Metabolic Crises Caused by Inherited Disorders of Organic and Amino Acid Metabolism
Author(s) -
GORTNER L.,
LEUPOLD D.,
POHLANDT F.,
BARTMANN P.
Publication year - 1989
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1989.tb11130.x
Subject(s) - medicine , peritoneal dialysis , metabolism , amino acid metabolism , dialysis , intensive care medicine , physiology
ABSTRACT. Four neonates who presented with coma secondary to hyperammonaemia resulting in central respiratory failure were treated with peritoneal dialysis for between 16 and 120 hours. Underlying diseases were maple‐syrup‐urine disease, propionic acidaemia and citrullinaemia in two patients. Clinical improvement was observed in three patients within 16 to 72 hours after institution of peritoneal dialysis. Biochemical analysis revealed a rapid reduction in plasma concentrations of leucine, isoleucine and valine as well as their alpha‐keto‐analogues in the infant suffering from maple‐syrup‐urine disease. Correction of ammonia, glycine, alanine and propionic acid concentrations was observed in the infant with propionic acidaemia 24–72 hours after institution of peritoneal dialysis. Severe hyperammonaemia (1000–2500 μmol/1) in two infants with citrullinaemia before peritoneal dialysis was treated successfully in one infant; whereas the second infant showed no clinical improvement despite amelioration of biochemical parameters. Glucose‐absorption from peritoneal dialysis solution was in the range of 216–441 mg/kg/h.