Carrasco AM, Rubio MA, Sanchez Tommero JA, Fernandez Girón F, Gonzalez Rico M, del Peso Gilsanz G, Fernandez Perpén A, Ramón RG, Bueno IF, Tranaeus A, Faict D, Hopwood A. Acidosis correction with a new 25 mmol/l bicarbonate/15 mmol/l lactate peritoneal dialysis solution.
Perit Dial Int 2001;
21:546-53. [PMID:
11783762]
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Abstract
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).
DESIGN
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.
SETTING
Four Spanish nephrology centers.
PATIENTS
Thirty-one (20 Bic/Lac, 11 Lac) well-dialyzed (creatinine clearance > 55 L/week/1.73 m2 body surface area) CAPD patients.
INTERVENTIONS
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.
MAIN OUTCOME MEASURE
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.
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