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Related Experiment Videos

Acetate versus lactate in peritoneal dialysis solutions.

F B Pedersen, N Ryttov, P Deleuran

    Nephron
    |January 1, 1985
    PubMed
    Summary

    Peritoneal dialysis solutions with acetate have higher acidity and take longer to reach a neutral pH compared to lactate solutions. Acetate solutions may cause abdominal pain, leading to a recommendation for lactate-based solutions.

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    Area of Science:

    • Nephrology
    • Biochemistry
    • Medical Technology

    Background:

    • Peritoneal dialysis solutions are crucial for patients with kidney failure.
    • The acid-base properties of dialysis solutions can impact patient comfort and outcomes.
    • Acetate and lactate are common buffering agents in these solutions.

    Purpose of the Study:

    • To compare the acid-base characteristics of lactate and acetate peritoneal dialysis solutions.
    • To evaluate the impact of these solutions on intraperitoneal pH over time.
    • To investigate the potential link between acetate solutions and adverse patient reactions.

    Main Methods:

    • Comparative analysis of acid-base parameters (titratable acid, buffer capacity) of lactate and acetate solutions.
    • Measurement of intraperitoneal pH changes after instilling 1.5 liters of each solution.

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  • Assessment of the time required for intraperitoneal pH to reach 7.

    • Main Results:

    • Acetate solutions exhibit significantly higher titratable acidity (5.58 mmol/l) than lactate solutions (0.79 mmol/l).
    • Buffer capacity is substantially greater in acetate solutions (11.43 mmol/l) compared to lactate solutions (1.82 mmol/l).
    • Intraperitoneal pH reached 7 in 18 minutes with acetate solutions versus 7 minutes with lactate solutions.

    Conclusions:

    • Differences in acid-base characteristics and potential acetate intolerance contribute to abdominal pain and irritation in some patients.
    • Neutralizing acetate solutions with sodium bicarbonate can lead to sodium overload.
    • Lactate-based peritoneal dialysis solutions are recommended over acetate-based ones.