Peritoneal and
extracorporeal dialysis are used to treat newborns affected by
inborn errors of metabolism to minimize the effects of the acute accumulation of neurotoxic metabolites that can produce irreversible and severe neurological damage and even death. In recent papers,
extracorporeal dialysis has been described as more effective than
peritoneal dialysis in improving the prognosis in newborns with
inborn errors of metabolism and
hyperammonemia. However, it appears that the outcome is primarily related to the duration of neonatal hyperammonemic
coma. Here we report seven newborns with
hyperammonemia caused by
inborn errors of metabolism (five with organic acidemias, two with
urea-cycle disorders). They received dietetic and pharmacological treatment as well as
peritoneal dialysis. Four of the five patients with organic acidemia survived with and without mild neurological impairment (follow-up 3.5-10 years). One died from bacterial
sepsis after
peritoneal dialysis was discontinued and the peritoneal
catheter was removed. One of the two patients affected by
urea-cycle disorders, a boy, died during the neonatal period, and the other, a girl, died at the age of 13 months due to severe neurological damage. Our results demonstrate that
peritoneal dialysis may still be an effective treatment for neonatal
hyperammonemia caused by
inborn errors of metabolism. Furthermore,
peritoneal dialysis can be administered quickly and easily in all settings, clearly an advantage when fast intervention is so crucial.