"Panel discussion: Inborn Errors of Metabolism perspectives from a Nephrologist" Stefano Picca, MD Department of Nephrology and Urology, Dialysis Unit Bambino Ges Pediatric Research Hospital, IRCCS ROMA, Italy In summary, it is recommended initially with pump-driven dialysis (ECMO/HD) followed by continuous hemofiltration with the same pump system. Statement #19. Grade of recommendation: C The method of choice for ammonia detoxification is hemodiafiltration. Peritoneal dialysis is a far less effective method PD remains an effective method for exogenous detoxification in newborns with hyperammonemia caused by metabolic diseases AMMONIUM CLEARANCE AND FILTRATION FRACTION USING DIFFERENT DIALYSIS MODALITIES Picca et al., 2001 Patient (n) Type of Dialysis Ammonium Clearance (ml/min) 4PD (1.41.1, about 0.48 ml/min/kg) Arbeiter et al., 2009 PROGNOSTIC INDICATORS IN DIALYZED AND NON-DIALYZED NEONATES: SURVIVAL Enns 2008 Early metabolic defect diagnosis Bachmann 2003 Initial pNH 4