Dialysis disequilibrium occurs due to a rapid shift of osmols when hemodialysis is used in cases of extreme uremia. Continuous veno-venous hemofiltration (CVVH) with citrate anticoagulation may offer a safe method of urea reduction.
Design.
Retrospective, clinical observation.
Setting.
Tertiary pediatric intensive care unit and nephrology program.
Patients
Two males, ages 10 and 12 years of age.
Intervention.
CVVH with citrate anticoagulation.
Results.
Three to four day reduction of BUN from 180 mg/dL to 22 mg/dL and from 279 mg/dL to 23 mg/dL.
Conclusion.
Slow and safe improvement of severe urea, hyperphosphatemia, hypocalcemia, and anemia without untoward side effects.
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