ArticleCritical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine2020
Continuous renal replacement therapy and its impact on hyperammonaemia in acute liver failure.
Article in Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- APASL clinical practice guidelines on the management of acute kidney injury in acute-on-chronic liver failure.Hepatology international · 2024Guideline
- Pre-Emptive Initiation of Continuous Renal Replacement Therapy in Patients With Acute Liver Failure With Cerebral Edema Improves Outcomes: A Randomized Controlled Trial.Alimentary pharmacology & therapeutics · 2026Trial
- Phoxilium® as a Phosphate-Sparing Solution for Continuous Renal Replacement Therapy in Paracetamol-Induced Acute Liver Failure.Blood purification · 2026Article
- Expanding the boundaries of kidney replacement therapy in patients with liver failure.World journal of critical care medicine · 2025Review
- Case Report: Management of intracranial hypertension in acute-on-chronic liver failure: a case of fulminant cerebral edema and acute-onset severe hyperammonemia in a patient with cirrhosis.Frontiers in gastroenterology (Lausanne, Switzerland) · 2025Article
- Diagnosis and management of pediatric acute liver failure: consensus recommendations of the Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ISPGHAN).Hepatology international · 2024Review
- Acute liver failure: A practical update.JHEP reports : innovation in hepatology · 2024Review
- Article
- Adverse events, short- and long-term outcomes of extra corporeal liver therapy in the intensive care unit: 16 years experience with MARS® in a single center.Critical care (London, England) · 2022Article
- Astragaloside IV improves the pharmacokinetics of febuxostat in rats with hyperuricemic nephropathy by regulating urea metabolism in gut microbiota.Frontiers in pharmacology · 2022Article
- Therapeutic plasma exchange in liver failure.World journal of hepatology · 2021Review
- Liver transplantation in acute liver failure: Dilemmas and challenges.World journal of transplantation · 2021Review
- Continuous Renal Replacement Therapy: A Review of Use and Application in Pediatric Hematopoietic Stem Cell Transplant Recipients.Frontiers in oncology · 2021Review
- Adverse Events and Outcomes of High-volume Plasma Exchange in 50 Acute Liver Failure Patients: A Monocentric Retrospective Real-world Study.Journal of clinical and experimental hepatologyArticle
Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveHyperammonaemia contributes to complications in acute liver failure (ALF) and may be treated with continuous renal replacement therapy (CRRT), but current practice is poorly understood.
designWe retrospectively analysed data for baseline characteristics, ammonia concentration, CRRT use, and outcomes in a cohort of Australian and New Zealand patients with ALF.
settingAll liver transplant ICUs across Australia and New Zealand.
participantsSixty-two patients with ALF.
main outcome measuresImpact of CRRT on hyperammonaemia and patient outcomes.
resultsWe studied 62 patients with ALF. The median initial (first 24 h) peak ammonia was 132 μmol/L (interquartile range [IQR], 91-172), median creatinine was 165 μmol/L (IQR, 92-263) and median urea was 6.9 mmol/L (IQR, 3.1-12.0). Most patients (43/62, 69%) received CRRT within a median of 6 hours (IQR, 2-12) of ICU admission. At CRRT commencement, three-quarters of such patients did not have Stage 3 acute kidney injury (AKI): ten patients (23%) had no KDIGO creatinine criteria for AKI, 12 (28%) only had Stage 1, and ten patients (23%) had Stage 2 AKI. Compared with non-CRRT patients, those treated with CRRT had higher ammonia concentrations (median, 141 μmol/L [IQR, 102-198]
conclusionIn Australian and New Zealand patients with ALF, CRRT is typically started early, before Stage 3 AKI or severe acidaemia, and in the presence hyperammonaemia. In these more severely ill patients, CRRT use was associated with prevention of extreme hyperammonaemia, which in turn, was associated with increased transplant-free survival.
Indexed as
Identifiers
32389108PMC10692487W4230411932What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.