A controlled trial of two bicarbonate-containing dialysis fluids for CAPD - Final report

Background. The combination of a low pH and a high concentration of lactate which is present in most dialysis fluids is found to be cytotoxic in vitro . For these reasons it would seem logical to use a bicarbonate-containing s olution and thus automatically provide a solution with a neutral pH. Methods. A parallel, randomized, open-label, prospective 2-month trial with an optional 4 month extension was undertaken to compare two novel bicarbon ate-based solutions; one containing 38 mmol/l of bicarbonate (B), and one c ontaining a mixture of 25 mmol/l bicarbonate and 15 mmol/l of lactate (B/L) , with a control solution (C) containing 40 mmol/l lactate. Results. Three groups of 19 (C), 20 (B), and 20 (B/L) patients were recruit ed and data from approximately 55 patient months were accumulated in each g roup. The data show that both bicarbonate-based solutions maintain acid-bas e levels within the normal range, that there were no changes in any of the other blood biochemistry parameters measured in the peritoneal equilibratio n test or with regard to adequacy of dialysis, and that furthermore, both s olutions were well tolerated. Conclusions. This study showed that either the bicarbonate or bicarbonate/l actate solutions could be utilized efficaciously in patients undergoing CAP D.