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

被引：79

作者：

Raina, Rupesh ^{[1
,2
]}

Bedoyan, Jirair K. ^{[3
,4
]}

Lichter-Konecki, Uta ^{[5
]}

Jouvet, Philippe ^{[6
]}

Picca, Stefano ^{[7
]}

Mew, Nicholas Ah ^{[8
]}

Machado, Marcel C. ^{[9
]}

Chakraborty, Ronith ^{[2
]}

Vemuganti, Meghana ^{[10
]}

Grewal, Manpreet K. ^{[11
]}

Bunchman, Timothy ^{[12
]}

Sethi, Sidharth Kumar ^{[13
]}

Krishnappa, Vinod ^{[2
,14
]}

McCulloch, Mignon ^{[15
]}

Alhasan, Khalid ^{[16
]}

Bagga, Arvind ^{[17
]}

Basu, Rajit K. ^{[18
]}

Schaefer, Franz ^{[19
]}

Filler, Guido ^{[20
]}

Warady, Bradley A. ^{[21
]}

机构：

[1] Akron Childrens Hosp, Dept Nephrol, Akron, OH 44308 USA

[2] Cleveland Clin Akron Gen, Akron Nephrol Associates, Akron, OH 44307 USA

[3] Univ Hosp Cleveland, Med Ctr, Ctr Human Genet, Cleveland, OH 44106 USA

[4] Case Western Reserve Univ, Dept Genet & Genome Sci, Cleveland, OH 44106 USA

[5] UPMC Childrens Hosp Pittsburgh, Div Med Genet, Pittsburgh, PA USA

[6] Univ Montreal, St Justine Hosp, Dept Paediat, Montreal, PQ, Canada

[7] Bambino Gesu Childrens Hosp & Res Inst, Dept Paediat, Div Nephrol & Dialysis, Rome, Italy

[8] George Washington Univ, Childrens Natl Rare Dis Inst, Washington, DC USA

[9] Univ Sao Paulo, Sch Med, Dept Emergency Med, Sao Paulo, Brazil

[10] Rainbow Babies & Childrens Hosp, Dept Pediat, Cleveland, OH 44106 USA

[11] Childrens Hosp Michigan, Dept Pediat Nephrol, Detroit, MI 48201 USA

[12] Virginia Commonwealth Univ, Pediat Nephrol & Transplantat, Childrens Hosp Richmond, Richmond, VA USA

[13] Medanta Med Hosp, Paediat Nephrol & Paediat Kidney Transplantat, Kidney & Urol Inst, Gurgaon, India

[14] Northeast Ohio Med Univ, Rootstown, OH USA

[15] Univ Cape Town, Red Cross War Mem Childrens Hosp, Cape Town, South Africa

[16] King Saud Univ, Coll Med, Dept Paediat, Riyadh, Saudi Arabia

[17] All India Inst Med Sci, Div Paediat Nephrol, New Delhi, India

[18] Childrens Healthcare Atlanta, Dept Pediat Crit Care Med, Atlanta, GA USA

[19] Univ Childrens Hosp Heidelberg, Div Paediat Nephrol, Heidelberg, Germany

[20] Western Univ, Dept Paediat, Div Paediat Nephrol, London, ON, Canada

[21] Univ Missouri, Sch Med, Div Nephrol, Childrens Mercy, Kansas City, MO 64108 USA

来源：

NATURE REVIEWS NEPHROLOGY | 2020年 / 16卷 / 08期

关键词：

EXTRACORPOREAL MEMBRANE-OXYGENATION; UREA CYCLE DISORDERS; CONTINUOUS VENOVENOUS HEMODIAFILTRATION; INBORN-ERRORS; PERITONEAL-DIALYSIS; COENZYME-A; HEMODIALYSIS; ENCEPHALOPATHY; HEMOFILTRATION; METABOLISM;

D O I：

10.1038/s41581-020-0267-8

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

This expert Consensus Statement from the Pediatric Continuous Renal Replacement Therapy (PCRRT) workgroup presents recommendations for the management of hyperammonaemia requiring kidney replacement therapy in paediatric populations. Additional studies are needed to strengthen these recommendations, which will be reviewed every 2 years. 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.

引用

页码：471 / 482

页数：12

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