title: Clinical experience with a new bicarbonate (25 mmol/L)/lactate (10 mmol/L) peritoneal dialysis solution.
abstract: OBJECTIVE
  Physiological bicarbonate/lactate-based solutions may correct acidosis in a better way than standard lactate-based solutions. In this study, a new 25 mmol/L bicarbonate/10 mmol/L lactate peritoneal dialysis (PD) solution was compared with a standard 35 mmolL lactate solution.
  
  
  METHODS
  This was a prospective open label study. All patients had a 2-week baseline period using the standard lactate solution, followed by 8 weeks on the bicarbonate/ lactate solution and 2 weeks on the lactate-based solution.
  
  
  METHODS
  Four Danish and four Spanish nephrology centers.
  
  
  METHODS
  40 well-dialyzed (creatinine clearance > 55 L/week/1.73 m2 body surface area) patients on continuous ambulatory PD.
  
  
  METHODS
  Blood samples were taken for biochemistry (including venous blood gases) at week -2, day 1, weeks 2, 4, and 8, and at follow-up. A physical examination, a peritoneal equilibration test (PET), and quality of life (K/DQOL), ultrafiltration, and adequacy assessments were performed at baseline and at week 8. Vital signs and other safety parameters were followed at each visit. Extraneal (Baxter Healthcare, Castlebar, Ireland) was used by all patients for the long dwell.
  
  
  METHODS
  Effect on the venous plasma bicarbonate level.
  
  
  RESULTS
  Venous plasma bicarbonate levels rose from 24.4 mmol/L when patients were on the pure lactate to 26.1 mmol/L when using the bicarbonate/lactate solution (p < 0.001). When patients were using the bicarbonate/ lactate solution, 66% of values were maintained within the venous normal range of 24-30 mmol/L, versus 46.2% when patients were on the pure lactate solution (p < 0.001). There were no adverse findings with respect to clinical symptoms, vital signs, or physical examination. The PET and adequacy, ultrafiltration, and K/DQOL assessment results were unchanged.
  
  
  CONCLUSIONS
  The new 25 mmol/L bicarbonate/ 10 mmol/L lactate solution provided better correction of acidosis than an equivalent 35 mmol/L standard lactate solution, without any safety issues.
authors.affiliation: Fredericia Sygehus Medicinsk afd, Fredericia, Denmark kot@fs.vejleamt.dk
authors.forename: Kjeld
authors.initials: K
authors.lastname: Otte
authors.forename: Maria Theresa
authors.initials: MT
authors.lastname: Gonzalez
authors.forename: Maria-Auxiliadora
authors.initials: MA
authors.lastname: Bajo
authors.forename: Gloria
authors.initials: G
authors.lastname: del Peso
authors.forename: James
authors.initials: J
authors.lastname: Heaf
authors.forename: Gorka
authors.initials: G
authors.lastname: Garcia Erauzkin
authors.forename: Jose A
authors.initials: JA
authors.lastname: Sanchez Tomero
authors.forename: Hans
authors.initials: H
authors.lastname: Dieperink
authors.forename: Johan
authors.initials: J
authors.lastname: Povlsen
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Hopwood
authors.forename: Jose C
authors.initials: JC
authors.lastname: Divino Filho
authors.forename: Dirk
authors.initials: D
authors.lastname: Faict
mesh_terms: D000138:Acidosis / Q000097:blood / Q000209:etiology* / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001639:Bicarbonates / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D002021:Buffers; D015314:Dialysis Solutions / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000628:therapy*; D019344:Lactic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D001639:Bicarbonates; D002021:Buffers; D015314:Dialysis Solutions; D004338:Drug Combinations; D019344:Lactic Acid