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To see if rapid lactate absorption on tidal peritoneal dialysis (TPD) would overwhelm D-lactate metabolism using racemic lactate and/or L-lactate metabolism using all L-lactate, five patients underwent 8-h TPD treatments with racemic lactate solution one day and with L-lactate another. Lactate concentrations (total) were 40 mmole/L, flow rates 27.3 L/8 h, tidal and reservoir volumes each 1.5L, tidal cycles 24-26 min, and net ultrafiltration per tidal cycle 70 to 99 mL. RESULTS Mean absorptions of D and L-lactate were 24.2 and 25.1%, respectively, compared to glucose at 14.6%. Urea clearances averaged 21.4 mL/min. Mean blood D-lactates at baseline were 0.6 +/- 0.5 SD mmole/L and after 8 h of TPD were 0.6 +/- 0.4 and 0.7 +/- 0.3 using L-lactate and racemic solutions, respectively; similar values for L-lactate were 1.2 +/- 0.3 at baseline and 1.2 +/- 0.3 and 1.2 +/- 0.5 after 8 h with L-lactate and racemic solutions. delta blood pH values were + 0.02 +/- 0.01 and + 0.04 +/- 0.03, while delta bicarbonate values were + 1.7 +/- 0.9 and + 0.7 +/- 1.0 for the all L and racemic studies, respectively. The total mmoles of L-lactate absorbed per 8 h of TPD with all L solution (greater than 300 mmoles) are greater than ever reported for peritoneal dialysis, but did not increase blood lactate levels. It would seem that either type of solution is suitable for TPD. Absorptions and metabolic rates are similar for L-Lactate and D-Lactate.
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Z J Twardowski, and
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L P Ponferrada, and
L M Schmidt, and
H L Moore
October 1993,
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K D Nolph, and
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H L Moore
January 1985,
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K D Nolph, and
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L M Schmidt, and
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January 1995,
Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis,
K D Nolph, and
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L P Ponferrada, and
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H L Moore
December 2003,
Kidney international. Supplement,
K D Nolph, and
Z J Twardowski, and
R Khanna, and
B F Prowant, and
L P Ponferrada, and
L M Schmidt, and
H L Moore
January 1992,
Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis,
K D Nolph, and
Z J Twardowski, and
R Khanna, and
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L P Ponferrada, and
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H L Moore
July 2014,
The Cochrane database of systematic reviews,
K D Nolph, and
Z J Twardowski, and
R Khanna, and
B F Prowant, and
L P Ponferrada, and
L M Schmidt, and
H L Moore
September 2010,
The Cochrane database of systematic reviews,
K D Nolph, and
Z J Twardowski, and
R Khanna, and
B F Prowant, and
L P Ponferrada, and
L M Schmidt, and
H L Moore
May 2001,
Acta pharmacologica Sinica,
K D Nolph, and
Z J Twardowski, and
R Khanna, and
B F Prowant, and
L P Ponferrada, and
L M Schmidt, and
H L Moore
June 2000,
Kidney international,
K D Nolph, and
Z J Twardowski, and
R Khanna, and
B F Prowant, and
L P Ponferrada, and
L M Schmidt, and
H L Moore
January 1993,
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