Clinical experience with a 39 mmol/L bicarbonate-buffered peritoneal dialysis solution

Area of Science:

• Nephrology
• Biochemistry
• Clinical Chemistry

Background:

• Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for end-stage renal disease.
• Maintaining acid-base balance is crucial for patients undergoing dialysis.
• Bicarbonate-buffered solutions are used in CAPD to manage metabolic acidosis.

Purpose of the Study:

• To evaluate the impact of a 39 mmol/L bicarbonate-buffered CAPD solution on patients' acid-base status.
• To compare the efficacy of a higher concentration bicarbonate solution against a standard one.

Main Methods:

• An open, controlled, cross-over study involving 9 patients.
• Patients were treated sequentially with 34 mmol/L and 39 mmol/L bicarbonate-buffered CAPD solutions.
• Acid-base parameters including venous and arterial blood pH and plasma bicarbonate were measured.

Main Results:

• The 39 mmol/L bicarbonate solution significantly increased plasma bicarbonate and arterial blood pH.
• Venous plasma bicarbonate levels rose significantly during treatment with the higher concentration solution.
• Changes in plasma bicarbonate correlated inversely with metabolic acid production and bicarbonate distribution space.

Conclusions:

• The 39 mmol/L bicarbonate-buffered CAPD solution effectively improves acid-base status in CAPD patients.
• Monitoring metabolic acid production and apparent distribution space for bicarbonate can help prevent metabolic alkalosis.
• This higher concentration bicarbonate solution offers a potential benefit for managing acid-base balance in CAPD.