Document Detail


Biocompatibility studies with bicarbonate-based solutions.
MedLine Citation:
PMID:  7999838     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
During long-term peritoneal dialysis (PD) treatment, the biocompatibility of the dialysis fluid is one of the factors that determine the functional integrity of the peritoneal mesothelium and stroma, and the alertness and functional capacity of the peritoneal host defense system. In vitro studies show that conventional acidic lactate-based PD solutions (LB fluids) are detrimental to some of the more important functions of the peritoneal cell system including mesothelial and white blood cells. The main toxic components of the fluids are the high hydrogen ion content (pH = 5-5.6), high lactate concentration, and osmolality. Some toxic side effects can be omitted using bicarbonate-based fluids (BB fluids), in which lactate has been replaced by bicarbonate and the pH has been normalized (7.2-7.4). The present paper is an overview of the biocompatibility tests and studies performed using bicarbonate-based continuous ambulatory peritoneal dialysis (CAPD) fluids. While the final long-term clinical evaluation of the BB fluids is still missing, biocompatibility tests indicate that these fluids are less toxic to many cell systems than the conventional acidic LB fluids. BB fluids with a high glucose content remain cytotoxic. The BB fluids are well tolerated in animal studies. Some BB fluids increase the ultrafiltration in short-term animal studies when compared with LB fluids. The few animal studies failed to demonstrate a better preservation of the peritoneal membrane integrity by BB fluids. The difference in cell toxicity between LB and BB fluids as measured in vitro also seems detectable during the first 30 min of intraperitoneal dwell in man.
Authors:
F B Pedersen
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Publication Detail:
Type:  In Vitro; Journal Article    
Journal Detail:
Title:  Advances in peritoneal dialysis. Conference on Peritoneal Dialysis     Volume:  10     ISSN:  1197-8554     ISO Abbreviation:  Adv Perit Dial     Publication Date:  1994  
Date Detail:
Created Date:  1995-01-24     Completed Date:  1995-01-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9104803     Medline TA:  Adv Perit Dial     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  245-50     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Odense University Hospital, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Animals
Bicarbonates* / analysis
Biocompatible Materials
Dialysis Solutions* / chemistry
Epithelial Cells
Epithelium / physiology
Fibroblasts / cytology,  physiology
Humans
Neutrophils / physiology
Peritoneal Dialysis, Continuous Ambulatory*
Peritoneum / cytology,  physiology
Chemical
Reg. No./Substance:
0/Bicarbonates; 0/Biocompatible Materials; 0/Dialysis Solutions

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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