Pedersen F B, Ryttov N, Deleuran P, Dragsholt C, Kildeberg P
Nephron. 1985;39(1):55-8. doi: 10.1159/000183338.
The acid-base characteristics of two peritoneal dialysis solutions containing either lactate or acetate are compared and the time course of changes in intraperitoneal pH following instillation into the abdominal cavity is measured. The concentration of titratable acid (cTA) is 5.58 mmol/l or 7 times as high in solutions containing acetate as in those containing lactate (0.79 mmol/l). The buffer capacity, -dcTA/dpH, is 11.43 and 1.82 mmol/l, respectively. Following intraperitoneal instillation of 1.5 liter of the solutions, the time course is 2-3 times as long before intraperitoneal pH reaches 7 using acetate (18 min) as when using lactate (7 min). The above mentioned difference in acid-base characteristics as well as an individual acetate intolerance is supposed to be the cause for the development of abdominal pains and peritoneal irritation observed in some patients using acetate-containing solutions. 123 mmol/l of sodium bicarbonate is to be added to the acetate solution to raise the pH value from 5.6 to 7.4. Neutralization using sodium bicarbonate will thus result in sodium intoxication of the patient. The use of lactate instead of acetate for peritoneal solutions is advocated.
比较了两种分别含有乳酸盐或醋酸盐的腹膜透析液的酸碱特性，并测量了将其注入腹腔后腹腔内pH值的变化时间进程。可滴定酸（cTA）的浓度在含醋酸盐的溶液中为5.58 mmol/l，是含乳酸盐溶液（0.79 mmol/l）的7倍。缓冲容量-dcTA/dpH分别为11.43和1.82 mmol/l。向腹腔内注入1.5升这两种溶液后，使用醋酸盐溶液时腹腔内pH值达到7所需的时间进程（18分钟）是使用乳酸盐溶液时（7分钟）的2至3倍。上述酸碱特性差异以及个体对醋酸盐的不耐受被认为是一些使用含醋酸盐溶液的患者出现腹痛和腹膜刺激的原因。需向醋酸盐溶液中添加123 mmol/l的碳酸氢钠，以使pH值从5.6升至7.4。因此，用碳酸氢钠中和会导致患者钠中毒。提倡在腹膜透析液中使用乳酸盐而非醋酸盐。
