PMID- 35042216
OWN - NLM
STAT- MEDLINE
DCOM- 20221019
LR  - 20221025
IS  - 1421-9735 (Electronic)
IS  - 0253-5068 (Linking)
VI  - 51
IP  - 10
DP  - 2022
TI  - Ammonia Clearance with Different Continuous Renal Replacement Therapy Techniques 
      in Patients with Liver Failure.
PG  - 840-846
LID - 10.1159/000521312 [doi]
AB  - INTRODUCTION: Continuous renal replacement therapy (CRRT) can be used to treat 
      hyperammonaemia. However, no study has assessed the effect of different CRRT 
      techniques on ammonia clearance. METHODS: We compared 3 different CRRT techniques 
      in adult patients with hyperammonaemia, liver failure, and acute kidney injury. 
      We protocolized CRRT to progressively deliver continuous veno-venous 
      haemofiltration (CVVH), haemodialysis (CVVHD) or haemodiafiltration (CVVHDF). 
      Ammonia was simultaneously sampled from the patient's arterial blood and effluent 
      fluid for each technique. We applied accepted equations to calculate clearance. 
      RESULTS: We studied 12 patients with a median age of 47 years (interquartile 
      range [IQR] 25-79). Acute liver failure was present in 4 (25%) and 
      acute-on-chronic liver failure in 8 (75%). There was no significant difference in 
      median ammonia clearance between CRRT technique; CVVH: 27 (IQR 23-32) mL/min 
      versus CVVHD: 21 (IQR 17-28) mL/min versus CVVHDF: 20 (IQR 14-28) mL/min, p = 
      0.32. Moreover, for all techniques, ammonia clearance was significantly less than 
      urea and creatinine clearance; urea 50 (47-54) mL/min versus creatinine 42 (IQR 
      38-46) mL/min versus ammonia 25 (IQR 18-29) mL/min, p = 0.0001. CONCLUSION: We 
      found no significant difference in ammonia clearance according to CRRT technique 
      and demonstrated that ammonia clearance is significantly less than urea or 
      creatinine clearance.
CI  - (c) 2022 S. Karger AG, Basel.
FAU - Fisher, Caleb
AU  - Fisher C
AD  - Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.
AD  - Department of Critical Care, The University of Melbourne, Melbourne, Victoria, 
      Australia.
FAU - Baldwin, Ian
AU  - Baldwin I
AD  - Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.
FAU - Fealy, Nigel
AU  - Fealy N
AD  - Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.
FAU - Naorungroj, Thummaporn
AU  - Naorungroj T
AD  - Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.
FAU - Bellomo, Rinaldo
AU  - Bellomo R
AD  - Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.
AD  - Department of Critical Care, The University of Melbourne, Melbourne, Victoria, 
      Australia.
AD  - Data Analytics Research and Evaluation Centre, The University of Melbourne and 
      Austin Hospital, Melbourne, Victoria, Australia.
AD  - Australian and New Zealand Intensive Care Research Centre, Monash University, 
      Melbourne, Victoria, Australia.
LA  - eng
PT  - Journal Article
DEP - 20220118
PL  - Switzerland
TA  - Blood Purif
JT  - Blood purification
JID - 8402040
RN  - 7664-41-7 (Ammonia)
RN  - 8W8T17847W (Urea)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - *Acute Kidney Injury/therapy
MH  - Adult
MH  - Ammonia
MH  - *Continuous Renal Replacement Therapy
MH  - Creatinine
MH  - Humans
MH  - *Hyperammonemia/therapy
MH  - *Liver Failure/therapy
MH  - Middle Aged
MH  - Renal Replacement Therapy/methods
MH  - Urea
OTO - NOTNLM
OT  - Ammonia
OT  - Clearance
OT  - Critical illness
OT  - Liver disease
OT  - Renal replacement therapy
EDAT- 2022/01/19 06:00
MHDA- 2022/10/20 06:00
CRDT- 2022/01/18 20:28
PHST- 2021/09/01 00:00 [received]
PHST- 2021/12/02 00:00 [accepted]
PHST- 2022/01/19 06:00 [pubmed]
PHST- 2022/10/20 06:00 [medline]
PHST- 2022/01/18 20:28 [entrez]
AID - 000521312 [pii]
AID - 10.1159/000521312 [doi]
PST - ppublish
SO  - Blood Purif. 2022;51(10):840-846. doi: 10.1159/000521312. Epub 2022 Jan 18.