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Perit Dial Int 26(1): 89-94 2006
© 2006 International Society for Peritoneal Dialysis
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Clinical

LONG-TERM CLINICAL EXPERIENCE WITH PURE BICARBONATE PERITONEAL DIALYSIS SOLUTIONS

Jesús Montenegro, Ramón M. Saracho, Isabel M. Martínez, Rosa I. Muñoz, Julian J. Ocharan and Evandro Valladares

Service of Nephrology, Hospital de Galdakao, Galdácano, Vizcaya, Spain

Correspondence to: J. Montenegro, Jefe del Servicio de Nefrología, Hospital de Galdakao, Barrio de Labeaga s/n, E 48960 Galdácano, Vizcaya, Spain.jmonten{at}hgda.osakidetza.net

{diamondsuit} Objectives: The aim of this prospective study was to collect long-term experience in incident peritoneal dialysis (PD) patients treated with pure bicarbonate-buffered PD fluids.

{diamondsuit} Methods: The metabolic parameters acidosis, acid–base status, adequacy, fluid balance, nutritional markers, calcium, phosphorus, parathyroid hormone (PTH), and general laboratory work and medication were compared between incident PD patients in two groups: one treated with a 34 mmol/L bicarbonate-buffered PD fluid (BIC), the other with a 35 mmol/L lactate-buffered PD fluid (LAC). The observation period included 5 visits from 1 month (visit 1) until 12 months (visit 5) after the start of dialysis treatment. For the descriptive analysis, means and standard deviations were calculated. Student's t-test and linear mixed models were used to compare the two treatment groups.

{diamondsuit} Results: 36 patients were followed for 12 months, 18 in the BIC group and 18 in the LAC group. Statistically significant differences between the groups (at the end of study) were found. In BIC group, venous plasma bicarbonate was 27.4 ± 2.3 mmol/L, base excess 0.8 ± 2.2 mmol/L, and pH 7.31 ± 0.05; in LAC group, venous bicarbonate was 25.9 ± 2.4 mmol/L, base excess –0.6 ± 2.1 mmol/L, and pH 7.30 ± 0.04. No patient from the BIC group needed oral bicarbonate, in contrast to 4 patients in the LAC group. Whereas peritoneal urea and creatinine clearances did not differ between the groups, there was better renal solute clearance in the BIC group, accompanied by better-preserved diuresis at 12 months (1333 ± 935 mL with BIC vs 839 ± 556 mL with LAC). The reverse was true for ultrafiltration.

{diamondsuit} Conclusions: Pure bicarbonate-buffered PD solutions were superior in correcting metabolic acidosis and they allowed omission of oral bicarbonate. The minor ultrafiltration with bicarbonate-buffered PD solutions was counterbalanced by better-preserved residual renal function with these solutions.

KEY WORDS: Acid–base status; bicarbonate; dialysis adequacy; residual renal function; ultrafiltration.

Received 2 April 2004; accepted 27 May 2005.




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J. Montenegro, R. Saracho, I. Gallardo, I. Martinez, R. Munoz, and N. Quintanilla
Use of pure bicarbonate-buffered peritoneal dialysis fluid reduces the incidence of CAPD peritonitis
Nephrol. Dial. Transplant., June 1, 2007; 22(6): 1703 - 1708.
[Abstract] [Full Text] [PDF]


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