Selgas R, Bajo M A, Fernandez-Reyes M J, Jimenez C, Del Peso G, Sanchez C, de Alvaro F
Hospital Universitario La Paz, Madrid, Spain.
Adv Perit Dial. 1996;12:49-52.
Lactate (L)-containing dialysate has a low pH, responsible for its poor biocompatibility. Dial-ysate-containing bicarbonate (B) with a physiological pH is available. We compare the peritoneal functional effects of these two solutions. Eight patients were studied two weeks apart using two consecutive peritoneal kinetic tests to determine convective and diffusive mass transfer coefficient (MTC) capacities for different solutes. Both L and B solutions were identical, except for pH and buffer content. Peritoneal equilibration values at four-hour dwell time were similar for all solutes, except for urea (B: 0.91 +/- 0.05 vs L: 0.87 +/- 0.06, p < 0.05). Peritoneal MTC (B vs L) values for urea (19.6 +/- 6.6 vs 18.2 +/- 4.5), creatinine (8.8 +/- 4.8 vs 7.8 +/- 3.5), phosphate (7.7 +/- 4.6 vs 6.0 +/- 2.2), and potassium (13.3 +/- 5.6 vs 11.7 +/- 5.0) were slightly higher for B (NS). Glucose-MTC was slightly lower for B (6.2 +/- 3.3 vs 7.5 +/- 3.2, NS). Ultrafiltration (UF) was lower for B (drained volume: 2120 +/- 204 vs 2443 +/- 285 mL after 4 hr, p < 0.05). Higher transperitoneal calcium [11 +/- 22 L vs -3.1 +/- 11.0 (positive balance) mg, p < 0.05] and sodium (48 +/- 30 L vs 13 +/- 20 mEq) removal were evident. With L, the loss of 43.0 +/- 6.3 mEq of bicarbonate appeared. The linear regression analysis of MTC values showed higher r coefficients for the bicarbonate solution. These results suggest that bicarbonate dial-ysate improves the diffusion capacity of the peritoneum with respect to lactate.
含乳酸（L）的透析液pH值较低，这导致其生物相容性较差。含生理pH值的碳酸氢盐（B）的透析液是可用的。我们比较了这两种溶液对腹膜功能的影响。对8名患者每隔两周进行一次研究，使用连续两次腹膜动力学测试来确定不同溶质的对流和扩散传质系数（MTC）能力。除了pH值和缓冲成分外，L溶液和B溶液是相同的。除尿素外，所有溶质在4小时驻留时间的腹膜平衡值相似（B：0.91±0.05 vs L：0.87±0.06，p<0.05）。B溶液的尿素（19.6±6.6 vs 18.2±4.5）、肌酐（8.8±4.8 vs 7.8±3.5）、磷酸盐（7.7±4.6 vs 6.0±2.2）和钾（13.3±5.6 vs 11.7±5.0）的腹膜MTC（B vs L）值略高（无显著性差异）。B溶液的葡萄糖-MTC略低（6.2±3.3 vs 7.5±3.2，无显著性差异）。B溶液的超滤（UF）较低（4小时后排出体积：2120±204 vs 2443±285 mL，p<0.05）。经腹膜钙的清除更高[11±22 L vs -3.1±11.0（正平衡）mg，p<0.05]，钠的清除也更明显（48±30 L vs 13±20 mEq）。使用L溶液时，出现了43.0±6.3 mEq碳酸氢盐的丢失。MTC值的线性回归分析显示，碳酸氢盐溶液的r系数更高。这些结果表明，碳酸氢盐透析液相对于乳酸可提高腹膜的扩散能力。
