title: Short-term effects of bicarbonate/lactate-buffered and conventional lactate-buffered dialysis solutions on peritoneal ultrafiltration: a comparative crossover study.
abstract: 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.
authors.affiliation: Department of Nephrology, University Medical Center Ljubljana, Zaloska 2, 1525 Ljubljana, Slovenia. jernej.pajek@mf.uni-lj.si
authors.forename: Jernej
authors.initials: J
authors.lastname: Pajek
authors.forename: Radoslav
authors.initials: R
authors.lastname: Kveder
authors.forename: Andrej
authors.initials: A
authors.lastname: Bren
authors.forename: Andrej
authors.initials: A
authors.lastname: Gucek
authors.forename: Maja
authors.initials: M
authors.lastname: Bucar
authors.forename: Andrej
authors.initials: A
authors.lastname: Skoberne
authors.forename: Jacek
authors.initials: J
authors.lastname: Waniewski
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
mesh_terms: 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
chemical_list: D001639:Bicarbonates; D001786:Blood Glucose; D015314:Dialysis Solutions; D007773:Lactates; D003404:Creatinine