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Bicarbonate: the alternative buffer for peritoneal dialysis

J Passlick-Deetjen1, J Kirchgessner

  • 1Fresenius AG, Bad Homburg, Germany.

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|January 1, 1996
PubMed
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Bicarbonate dialysis solutions offer a promising alternative to lactate, improving patient comfort and correcting acidosis. Individualized concentrations enhance efficacy, especially for severe metabolic acidosis.

Area of Science:

  • Nephrology
  • Biochemistry
  • Medical Technology

Background:

  • Lactate has been favored in peritoneal dialysis due to technical challenges with bicarbonate solutions.
  • Lactate solutions present potential biocompatibility and metabolic concerns for patients.

Purpose of the Study:

  • To evaluate bicarbonate as a buffer in peritoneal dialysis, overcoming previous limitations.
  • To compare the efficacy and patient tolerance of bicarbonate versus lactate dialysis solutions.

Main Methods:

  • Development of novel bicarbonate-containing dialysis fluid formulations and delivery systems.
  • In vitro, animal, and clinical studies, including a randomized multicenter trial and pilot studies.

Main Results:

Related Experiment Videos

  • Bicarbonate fluids demonstrate improved cell viability and function in preclinical studies.
  • Clinical trials show bicarbonate solutions reduce inflow pain, are well-tolerated, and can correct metabolic acidosis.
  • Higher bicarbonate concentrations effectively increase arterial bicarbonate levels in patients with severe acidosis.

    • Conclusions:

    • Bicarbonate-based peritoneal dialysis solutions are a viable and potentially superior alternative to lactate.
    • Individualized bicarbonate concentrations are crucial for optimizing treatment outcomes in peritoneal dialysis patients.