دورية أكاديمية
Short-term results of continuous venovenous haemodiafiltration versus peritoneal dialysis in 40 neonates with inborn errors of metabolism.
العنوان: | Short-term results of continuous venovenous haemodiafiltration versus peritoneal dialysis in 40 neonates with inborn errors of metabolism. |
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المؤلفون: | Celik M; Department of Pediatrics, Division of Neonatology, Gaziantep University, Osmangazi Mahallesi, Üniversite Blv., 27310 Şehitkamil, Gaziantep, Turkey. mehdincelik@hotmail.com., Akdeniz O; Department of Pediatrics, Division of Pediatric Cardiology, Diyarbakir Children's Diseases Hospital, Diyarbakir, Turkey., Ozgun N; Department of Pediatrics, Division of Pediatric Neurology, Diyarbakir Children's Diseases Hospital, Diyarbakir, Turkey., Ipek MS; Department of Pediatrics, Division of Neonatology, Memorial Dicle Hospital, Diyarbakir, Turkey., Ozbek MN; Department of Pediatrics, Division of Pediatric Endocrinology and Metabolism, Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey. |
المصدر: | European journal of pediatrics [Eur J Pediatr] 2019 Jun; Vol. 178 (6), pp. 829-836. Date of Electronic Publication: 2019 Mar 20. |
نوع المنشور: | Comparative Study; Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Verlag Country of Publication: Germany NLM ID: 7603873 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1076 (Electronic) Linking ISSN: 03406199 NLM ISO Abbreviation: Eur J Pediatr Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Berlin : Springer Verlag Original Publication: Berlin, New York, Springer-Verlag. |
مواضيع طبية MeSH: | Ammonia/*blood , Hemodiafiltration/*mortality , Metabolism, Inborn Errors/*therapy , Renal Dialysis/*mortality, Ammonia/pharmacokinetics ; Female ; Hemodiafiltration/methods ; Humans ; Infant, Newborn ; Male ; Metabolism, Inborn Errors/mortality ; Renal Dialysis/methods ; Retrospective Studies ; Treatment Outcome |
مستخلص: | Several recent studies have reported that toxic metabolites accumulated in the body as a product of inborn errors of metabolism (IEM) are eliminated more rapidly with continuous venovenous hemodiafiltration (CVVHDF) than with peritoneal dialysis (PD). However, there is still uncertainty about the impacts of dialysis modalities on the short-term outcome. Here, it was aimed to investigate the effects of dialysis modalities on the short-term outcome. This retrospective study included 40 newborn infants who underwent PD (29 patients) or CVVHDF (11 patients) due to inborn errors of metabolism at a tertiary centre, between June 2013 and March 2018. The outcomes and the potential effects of the dialysis modality were evaluated. Of 40 patients, 21 were urea cycle defect, 14 were organic academia, and 5 were maple syrup urine disease. The median 50% reduction time of toxic metabolites were shorter in patients treated with CVVHDF (p < 0.05). Catheter blockage was the most common complication observed in PD group (24.1%), whereas in CVVHDF group hypotension and filter blockage were more common. There was no significant difference in mortality between dialysis groups (38% vs. 45.4%, p > 0.05). In patients with hyperammonaemia, duration of plasma ammonia > 200 μg/dL was the most important factor influencing mortality (OR 1.05, CI 1.01-1.09, p = 0.007).Conclusion: This study showed that CVVHDF is more efficient than PD to rapidly eliminate toxic metabolites caused by IEM in newborn infants, but not in improving survival. What is Known: •Toxic metabolites are eliminated more rapidly with CVVHDF than with PD. •Higher complication rates were reported with rigid peritoneal catheters in PD and catheter blockage in CVVHDF. What is New: •Prolonged duration of plasma ammonia levels above a safe limit (200 μg/dL) was associated with increased mortality. •Lower catheter-related complication rates may have been associated with the use of Tenckhoff catheters in PD and the use of right internal jugular vein in CVVHDF. |
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فهرسة مساهمة: | Keywords: Continuous venovenous hemodiafiltration; Inborn errors of metabolism; Newborn; Peritoneal dialysis |
المشرفين على المادة: | 7664-41-7 (Ammonia) |
تواريخ الأحداث: | Date Created: 20190322 Date Completed: 20191224 Latest Revision: 20200225 |
رمز التحديث: | 20221213 |
DOI: | 10.1007/s00431-019-03361-4 |
PMID: | 30895385 |
قاعدة البيانات: | MEDLINE |
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