Otte Kjeld, Gonzalez Maria Theresa, Bajo Maria-Auxiliadora, del Peso Gloria, Heaf James, Garcia Erauzkin Gorka, Sanchez Tomero Jose A, Dieperink Hans, Povlsen Johan, Hopwood Alexandra M, Divino Filho Jose C, Faict Dirk
Fredericia Sygehus Medicinsk afd, Fredericia, Denmark
Perit Dial Int. 2003 Mar-Apr;23(2):138-45.
Physiological bicarbonate/lactate-based solutions may correct acidosis in a better way than standard lactate-based solutions. In this study, a new 25 mmol/L bicarbonate/10 mmol/L lactate peritoneal dialysis (PD) solution was compared with a standard 35 mmolL lactate solution.
This was a prospective open label study. All patients had a 2-week baseline period using the standard lactate solution, followed by 8 weeks on the bicarbonate/ lactate solution and 2 weeks on the lactate-based solution.
Four Danish and four Spanish nephrology centers.
40 well-dialyzed (creatinine clearance > 55 L/week/1.73 m2 body surface area) patients on continuous ambulatory PD.
Blood samples were taken for biochemistry (including venous blood gases) at week -2, day 1, weeks 2, 4, and 8, and at follow-up. A physical examination, a peritoneal equilibration test (PET), and quality of life (K/DQOL), ultrafiltration, and adequacy assessments were performed at baseline and at week 8. Vital signs and other safety parameters were followed at each visit. Extraneal (Baxter Healthcare, Castlebar, Ireland) was used by all patients for the long dwell.
Effect on the venous plasma bicarbonate level.
Venous plasma bicarbonate levels rose from 24.4 mmol/L when patients were on the pure lactate to 26.1 mmol/L when using the bicarbonate/lactate solution (p < 0.001). When patients were using the bicarbonate/ lactate solution, 66% of values were maintained within the venous normal range of 24-30 mmol/L, versus 46.2% when patients were on the pure lactate solution (p < 0.001). There were no adverse findings with respect to clinical symptoms, vital signs, or physical examination. The PET and adequacy, ultrafiltration, and K/DQOL assessment results were unchanged.
The new 25 mmol/L bicarbonate/ 10 mmol/L lactate solution provided better correction of acidosis than an equivalent 35 mmol/L standard lactate solution, without any safety issues.
基于生理碳酸氢盐/乳酸盐的溶液可能比标准的基于乳酸盐的溶液能更好地纠正酸中毒。在本研究中，将一种新的25 mmol/L碳酸氢盐/10 mmol/L乳酸盐腹膜透析（PD）溶液与一种标准的35 mmol/L乳酸盐溶液进行比较。
这是一项前瞻性开放标签研究。所有患者先使用标准乳酸盐溶液进行为期2周的基线期，随后使用碳酸氢盐/乳酸盐溶液8周，再使用基于乳酸盐的溶液2周。
四个丹麦和四个西班牙肾脏病中心。
40例接受持续性非卧床腹膜透析且透析充分（肌酐清除率>55 L/周/1.73 m²体表面积）的患者。
在第-2周、第1天、第2周、第4周、第8周以及随访时采集血样进行生化检测（包括静脉血气分析）。在基线期和第8周进行体格检查、腹膜平衡试验（PET）以及生活质量（K/DQOL）、超滤和充分性评估。每次就诊时监测生命体征和其他安全参数。所有患者长期驻留均使用Extraneal（百特医疗保健公司，爱尔兰卡斯尔巴）。
对静脉血浆碳酸氢盐水平的影响。
静脉血浆碳酸氢盐水平从患者使用纯乳酸盐溶液时的24.4 mmol/L升至使用碳酸氢盐/乳酸盐溶液时的26.1 mmol/L（p<0.001）。当患者使用碳酸氢盐/乳酸盐溶液时，66%的值维持在24 - 30 mmol/L的静脉正常范围内，而使用纯乳酸盐溶液时这一比例为46.2%（p<0.001）。在临床症状、生命体征或体格检查方面未发现不良结果。PET以及充分性、超滤和K/DQOL评估结果未发生变化。
新的25 mmol/L碳酸氢盐/10 mmol/L乳酸盐溶液比同等的35 mmol/L标准乳酸盐溶液能更好地纠正酸中毒，且无任何安全问题。
