Kidney Week

Abstract: SA-PO692

Comparison of Two Different Neutral Peritoneal Dialysis Fluids in Japan, Bicarbonate/Lactate-Buffered Fluid versus Lactate-Buffered Fluid

Session Information

• Peritoneal Dialysis - II
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

• 608 Peritoneal Dialysis

Authors

• Tanno, Yudo, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

Yudo Tanno,

• Matsuo, Nanae, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

Nanae Matsuo,

• Maruyama, Yukio, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

Yukio Maruyama,

• Ohkido, Ichiro, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

Ichiro Ohkido,

• Yokoyama, Keitaro, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

Keitaro Yokoyama,

• Yokoo, Takashi, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

Takashi Yokoo,

Background

Recently, new neutral peritoneal dialysis fluid (PDF) contained bicarbonate 25mEq/L and lactate 10mEq/L (Bic/Lac PDF), instead of lactate 40mEq/L contained neutral fluid (Lac PDF), was available in Japan. Bic/Lac PDF is expected to achieve better biocompatibility and to compensate overcorrection of metabolic acidosis by reducing total alkaline buffer. However, there are few reports comparing Bic/Lac PDF and neutral Lac PDF. Therefore, we conducted a prospective study to clarify the effect of Bic/Lac PDF on clinical status including acid-base disturbance.

Methods

Sixty-three stable PD patients were included (60±12 y/o, male 76%, PD duration 43.6±30.2 months). All PDF contained 40 mEq/L of lactate before changing to Bic/Lac PDF, and the daily volume of PDF was not changed until the end of the examination period. The patient’s existing medications were not changed during the study period. The patients’ data (bicarbonate, pH, ionized calcium, carbon dioxide and Lactate levels) were obtained before and 3 months after the induction of Bic/Lac PDF. We also investigated the change in effluent drain volume, D/P creatinine ratio from the 4-hour peritoneal equilibration test and residual renal function.

Results

After switching PDF, bicarbonate and carbon dioxide were decreased significantly (26.5±2.8 vs. 24.4±2.6 mEq/L; P<0.01, 46.6±6.4 vs. 43.2±5.8 mmHg; P<0.01, respectively). Patients treated with low dose PDF (3.3±0.5 L/day) demonstrated insufficient correction of metabolic acidosis (bicarbonate 24.0±2.7 vs. 21.9±3.8 mEq/L; P<0.01) as compared with middle dose PDF (5.6±0.6 L/day, bicarbonate 26.7±2.2 vs. 23.9±2.0 mEq/L; P<0.01) and high dose PDF (7.5±1.0 L/day, bicarbonate 29.7±2.5 vs. 26.8±1.6 mEq/L; P<0.01). Whereas, other parameters did not change significantly between before and after induction of Bic/Lac PDF.

Conclusion

The new Bic/Lac PDF is effective for overcorrection of metabolic acidosis in PD patients, although it must be carefully managed in such a patient who is treated with low dose PDF.

Funding

• Commercial Support – Baxter