A comparison between the effects of acetate and lactate in peritoneal dialysis solutions

A comparison was carried out regarding peritoneal dialysis using acetate in preference to lactate as the buffer anion in the dialysis solution. The investigation was made with 5 patients on long-term peritoneal dialysis once a week, first for 5 weeks with dialysis solution containing acetate and then, correspondingly, 5 dialyses with peritoneal solution containing lactate. A tendency to a slightly higher standard bicarbonate level at the end of dialysis was found when using the solution containing acetate. Furthermore, it appeared that total calcium and ionized calcium values were higher at the end of dialysis with the solution containing lactate. The latter may be ascribed to a difference in the degree of chelate binding of calcium in the two solutions. There were no differences in hemoglobin, s-sodium, s-potassium, s-urea, s-creatinine, s-phosphate and blood pressure values before and after dialysis with the two solutions. It is concluded that lactate scarcely offers any advantages in preference to acetate in peritoneal dialysis.