title: High serum D-lactate in patients on continuous ambulatory peritoneal dialysis.
abstract: BACKGROUND
  As abnormally high serum D-lactate levels may cause neurological impairment, we determined whether patients undergoing continuous ambulatory peritoneal dialysis (CAPD) with lactate-containing fluids have increased serum D-lactate concentrations.
  
  
  METHODS
  D- and L-lactate concentrations were determined in peritoneal dialysis fluids and in serum from control subjects (n = 10), haemodialysis patients (n = 10), and CAPD patients (n = 30) before and after 1 h of dialysis.
  
  
  RESULTS
  We found the median D-lactate concentration in Dianeal CAPD fluid to be 26 mM (range 19-27), whereas it was less than 0.5 mM in DPCA2 fluid. Control, haemodialysis, and CAPD (DPCA2) patient median serum D-lactate concentrations were below 0.07 mM. However, CAPD (Dianeal) patient serum D-lactate concentrations were 4-fold higher than controls (P < 0.0001), at 0.28 mM, an hour after instillation of D-lactate-containing fluid. Three patients, whose serum D-lactate averaged 0.59 mM, were found to have D-lactate concentrations at 0.22 mM after overnight cessation of dialysis.
  
  
  CONCLUSIONS
  We conclude that CAPD with D-lactate-containing fluids raises serum D-lactate to abnormal levels.
authors.affiliation: Department of Biochemistry, University of Oxford, UK.
authors.forename: Y S
authors.initials: YS
authors.lastname: Anderson
authors.forename: N J
authors.initials: NJ
authors.lastname: Curtis
authors.forename: J A
authors.initials: JA
authors.lastname: Hobbs
authors.forename: C H
authors.initials: CH
authors.lastname: Thompson
authors.forename: C G
authors.initials: CG
authors.lastname: Winearls
authors.forename: G K
authors.initials: GK
authors.lastname: Radda
authors.forename: K
authors.initials: K
authors.lastname: Clarke
authors.forename: P
authors.initials: P
authors.lastname: Altmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015314:Dialysis Solutions / Q000032:analysis; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D019344:Lactic Acid / Q000097:blood* / Q000737:chemistry / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000097:blood / Q000209:etiology; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D006435:Renal Dialysis; D013237:Stereoisomerism
chemical_list: D015314:Dialysis Solutions; D019344:Lactic Acid