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2020 | 3 | 1 | 11-15
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Effect of a bicarbonate-buffered peritoneal dialysis solution on clinical and laboratory indices of dialysis adequacy

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Background Biocompatible fluids were introduced to improve dialysis and patient outcome in end-stage renal disease. However, being buffered with lactate, they may insufficiently correct metabolic acidosis, and lead to changes in peritoneum structure. Bicarbonate buffered fluids might mitigate these complications. The aim of the study was to evaluate the influence of a bicarbonate dialysis fluid on clinical and laboratory indices of dialysis adequacy. Material and methods 20 prevalent peritoneal dialysis (PD) patients created two groups. One group continued on lactate fluid, the other changed to bicarbonate solution. Clinical and laboratory indices of dialysis adequacy were evaluated at baseline, and at six weeks intervals for 24 weeks. Results In bicarbonate group, pH was 7.36±0.03, HCO3 22.1±1.8 mmol/l at baseline and 7.36±0.04 and 21.2± 2.3 mmol/l at 24 weeks, while in controls pH equaled 7.35±0.12, HCO3 22.2±1.4 mmol/l, at baseline, and 7.40±0.03, and 22.3±1.8 mmol/l, at 24 weeks, with no significant differences. Dialysis adequacy (urea Kt/V), urine output and dialysis ultrafiltration did not differ between the groups, either at baseline or at study termination. Conclusions Bicarbonate PD solution appears to be similar to standard fluid in the impact on hydration status and on acid/base balance. Longitudinal studies are needed to assess long-term advantages of these biocompatible solutions.
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