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Related Concept Videos

Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

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Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
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Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

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Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
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Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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Urea Cycle01:23

Urea Cycle

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The urea cycle describes how liver cells convert ammonia to urea. Ammonia is a toxic waste product of protein catabolism. Land animals must convert ammonia into the less toxic urea which can be safely eliminated by the kidneys through urine. Marine animals excrete ammonia directly, and the surrounding water dilutes the ammonia to safe levels.
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Chronic Kidney Disease III: Interprofessional Care01:28

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Renal Regulation of Acid-Base Balance01:29

Renal Regulation of Acid-Base Balance

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Metabolic reactions in the body produce nonvolatile acids, such as sulfuric acid, which generate an acid load of approximately 1 mEq of H+ per kilogram of body weight daily. Excreting H+ in the urine is essential to balance this acid load.
In the kidneys, cells within the proximal convoluted tubules (PCT) and the collecting ducts secrete hydrogen ions (H+) into the tubular fluid. Specifically, in the PCT, Na+/H+ antiporters secrete H+ while reabsorbing Na+.
However, the intercalated cells in...
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Related Experiment Video

Updated: Oct 12, 2025

Epithelial Cell Repopulation and Preparation of Rodent Extracellular Matrix Scaffolds for Renal Tissue Development
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Continuous Renal Replacement Therapy for Two Neonates With Hyperammonemia.

Christopher Markham1, Caroline Williams1, Cory Miller1

  • 1Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States.

Frontiers in Pediatrics
|November 22, 2021
PubMed
Summary
This summary is machine-generated.

Continuous renal replacement therapy (CRRT) effectively clears ammonia in infants with inborn errors of metabolism. This hemofiltration method is feasible for rapid ammonia removal in low birth weight infants.

Keywords:
citrullinemiahemodialysishyperammonemiamethylmalonic acidemianeonate

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Area of Science:

  • Pediatric Nephrology
  • Metabolic Disorders
  • Critical Care Medicine

Background:

  • Inborn errors of metabolism can cause severe hyperammonemia in infants.
  • Low body weight infants present unique challenges for ammonia clearance therapies.
  • Scavenger therapy alone may be insufficient for rapid ammonia reduction.

Purpose of the Study:

  • To evaluate the feasibility of hemofiltration for ammonia removal in low birth weight infants.
  • To compare the efficacy of continuous renal replacement therapy (CRRT) with scavenger therapy for hyperammonemia.
  • To assess ammonia clearance rates using CRRT in infants with inborn errors of metabolism.

Main Methods:

  • Case study design involving two infants.
  • Implementation of continuous renal replacement therapy (CRRT) in a pediatric intensive care setting.
  • Monitoring of serum ammonia levels and clearance rates over time.

Main Results:

  • CRRT demonstrated superior efficacy compared to scavenger therapy (Ammonul™) for ammonia removal.
  • Rapid reduction of serum ammonia levels was achieved with CRRT.
  • Hemofiltration via CRRT proved effective even in infants as small as 2.5 kg.

Conclusions:

  • Continuous renal replacement therapy (CRRT) is a technically feasible and effective treatment for severe hyperammonemia in low birth weight infants.
  • CRRT offers a viable option for managing hyperammonemia secondary to inborn errors of metabolism in critically ill neonates.
  • Hemofiltration should be considered as a therapeutic strategy for rapid ammonia detoxification in vulnerable infant populations.