In vitro biocompatibility of bicarbonate-based peritoneal dialysis solutions.
OBJECTIVE
To review the current literature on the in vitro biocompatibility of peritoneal dialysis solutions buffered with bicarbonate and compare them to existing conventional lactate-buffered solutions.


RESULTS
Conventional lactate-buffered solutions are known to inhibit or modulate cell functions related to host defense mechanisms; these effects are mediated by their low pH in combination with lactate concentration, as well as their glucose content, associated osmolality, and the presence of glucose breakdown products.


CONCLUSIONS
Bicarbonate-buffered solutions appear to present a viable alternative for use in CAPD based on their significantly improved biocompatibility profile. The results of on-going clinical trials will clarify whether these in vitro data will impact significantly on peritoneal host defence, infection rate and the long term function of the peritoneal membrane in vivo.
Topley
N
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Institute of Nephrology, University of Wales College of Medicine, Cardiff Royal Infirmary, Wales.
D001639:Bicarbonates; D001672:Biocompatible Materials; D002021:Buffers; D015314:Dialysis Solutions; D006801:Humans; D006863:Hydrogen-Ion Concentration; D019344:Lactic Acid; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000187:drug effects / Q000378:metabolism
D001639:Bicarbonates; D001672:Biocompatible Materials; D002021:Buffers; D015314:Dialysis Solutions; D019344:Lactic Acid