PERITONEAL-DIALYSIS (PD) SOLUTIONS AND PERITONEAL EXCHANGE - ACUTE AND LONG-TERM EFFECTS

Two bicarbonate buffered glucose-based neutral peritoneal dialysis (PD ) solutions (BNS) were investigated and compared to a conventional aci dic glucose-based solution (pH 5.8) containing lactate as a buffer (Lo ckolys 2.3%) (CS) with respect to peritoneal transport characteristics for small and large solutes during acute PD in Wistar rats. Theoretic ally, neutral solutions would cause less initial vasodilatation and ir ritation than conventional acidic solutions (CS) during PD dwells. How ever, although there was a tendency towards reduced mass-transfer area coefficients IFS) for glucose and Cr-51-EDTA in the BNS, this differe nce was not statistically significant. The same applied to the ultrafi ltration (UF) profiles. Despite a tendency towards improved ultrafiltr ation with the bicarbonate solutions, the difference was: only margina lly significant for one of the investigated BNS. The results are in li ne with a number of clinical studies of BNS vs. CS, indicating unalter ed UF characteristics for the BNS. Furthermore, the present data indic ate that albumin kinetics across the peritoneal membrane, including pe ritoneal dialysate-to-plasma clearance of albumin (Cl --> P) were not significantly affected by either dialysate pH, or the choice of buffer in the solutions.