Short-term effects of bicarbonate/lactate-buffered and conventional lactate-buffered dialysis solutions on peritoneal ultrafiltration: a comparative crossover study.
BACKGROUND
This study was designed to compare the effects of a conventional lactate-based peritoneal dialysis (PD) solution (D) and a new biocompatible bicarbonate/lactate-based solution with a low concentration of glucose degradation products (P) on peritoneal ultrafiltration (UF) and other peritoneal membrane indices.


METHODS
Twenty-six stable, prevalent PD patients were enrolled in this prospective study. They sequentially underwent 3 months of therapy with the D solution and 3 months with the P solution in a randomized order. Daily, overnight and 4-h UF on PET were measured and other peritoneal membrane indices were also assessed using PET with 2.27% glucose solution.


RESULTS
Twenty-one patients successfully completed the study. The mean daily peritoneal UF with D was 1324 +/- 602 ml and 881 +/- 633 ml with P (P < 0.001) and this lower daily UF of 443 ml (95% CI 275-610 ml) with P was associated with a similarly lower daily total fluid removal of 394 ml (95% CI 210-577 ml), as urine volume did not differ between D and P. The decrement in UF with the P solution was reversible. There were no significant differences in other peritoneal membrane indices (D/P creatinine, D/D0 glucose, 4-h UF at PET, weekly creatinine clearance, weekly urea Kt/V) or blood pressure and body weight between the solutions whereas calculated peritoneal fluid absorption rate was significantly higher with the P than with the D solution.


CONCLUSIONS
This study shows that the daily UF with the P solution may be lower than with the D solution. The mechanism for this short-term and reversible effect that conceivably reflects differences in biocompatibility is not clear although our results implicate that the peritoneal fluid absorption rate may differ between the two solutions.
Pajek
Jernej
J
Department of Nephrology, University Medical Center Ljubljana, Zaloska 2, 1525 Ljubljana, Slovenia. jernej.pajek@mf.uni-lj.si
Kveder
Radoslav
R
Bren
Andrej
A
Gucek
Andrej
A
Bucar
Maja
M
Skoberne
Andrej
A
Waniewski
Jacek
J
Lindholm
Bengt
B
D000328:Adult; D000368:Aged; D001639:Bicarbonates; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D003404:Creatinine / Q000097:blood; D018592:Cross-Over Studies; D015314:Dialysis Solutions; D005260:Female; D017583:Hemodiafiltration / Q000379:methods*; D006801:Humans; D007674:Kidney Diseases / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D007773:Lactates; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome
D001639:Bicarbonates; D001786:Blood Glucose; D015314:Dialysis Solutions; D007773:Lactates; D003404:Creatinine