Acidosis correction with a new 25 mmol/l bicarbonate/15 mmol/l lactate peritoneal dialysis solution.
OBJECTIVE
The aim of this study was to evaluate the effects of a combined 25 mmol/L bicarbonate/15 mmol/L lactate-based solution (Bic/Lac), compared to a 35 mmol/L lactate solution (Lac)--the most commonly used solution for patients in southern Europe--on the venous plasma bicarbonate level in patients treated with continuous ambulatory peritoneal dialysis (CAPD).


METHODS
This was a randomized, parallel, controlled, open-label study, with patients studied for a period of 3 months preceded by a 1-month baseline and followed by a 1-month follow-up. Patients used the 35 mmol/L lactate solution during baseline and follow-up periods.


METHODS
Four Spanish nephrology centers.


METHODS
Thirty-one (20 Bic/Lac, 11 Lac) well-dialyzed (creatinine clearance > 55 L/week/1.73 m2 body surface area) CAPD patients.


METHODS
Blood samples were taken for biochemistry tests at all visits. A physical examination was completed at baseline and month 3, and a medical update was completed after 1, 2, and 3 months, and at the follow-up visit. Adverse-event monitoring and notation of prescription changes were carried out continuously.


METHODS
Effect on venous plasma bicarbonate level.


RESULTS
Venous plasma bicarbonate rose by 3.1 mmol/L (confidence intervals 1.6-4.8),from a baseline level of 23.0 mmol/L during the treatment period in those patients treated with Bic/Lac (p < 0.05 vs Lac). The number of acidotic patients (venous plasma bicarbonate < 24 mmol/L) was statistically significantly reduced at every treatment period visit in the Bic/Lac group (p < 0.05). There were no adverse findings with respect to vital signs, physical examination, or clinical symptoms, apart from one death in the control group.


CONCLUSIONS
The new Bic/Lac solution allowed better correction of acid-base status than the lactate solution.
Carrasco
A M
AM
Hospital Clinico Universitario, Valencia, Spain.
Rubio
M A
MA
Sanchez Tommero
J A
JA
Fernandez Girón
F
F
Gonzalez Rico
M
M
del Peso Gilsanz
G
G
Fernandez Perpén
A
A
Ramón
R G
RG
Bueno
I F
IF
Tranaeus
A
A
Faict
D
D
Hopwood
A
A
D000138:Acidosis / Q000628:therapy*; D000328:Adult; D000368:Aged; D001639:Bicarbonates / Q000097:blood / Q000627:therapeutic use*; D015314:Dialysis Solutions; D005260:Female; D006801:Humans; D007773:Lactates / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome
D001639:Bicarbonates; D015314:Dialysis Solutions; D007773:Lactates