Use of bicarbonate/lactate-buffered dialysate with a nighttime cycler, associated with a daytime dwell with icodextrin, may result in alkalosis in children

Adv Perit Dial. 2004:20:222-5.

Abstract

The aim of peritoneal dialysis (PD) remains to deliver "appropriate" renal replacement therapy, including sufficient ultrafiltration, correction of acid-base balance, and adequate dialysis dose. We switched our pediatric patients on automated PD from standard lactate-buffered glucose solution (Dianeal: Baxter Healthcare SA, Castlebar, Ireland) to bicarbonate/lactate-buffered solution (Physioneal: Baxter Healthcare SA) as soon as it became available in our country. We also decided to deliver "optimal" dialysis in children by prescribing a long daytime dwell with icodextrin solution (Extraneal: Baxter Healthcare SA). But, adding those three benefits together--APD, Physioneal, and a long dwell with icodextrin--the result, at least in children, was a possible overcorrection of acidosis and an evolution to alkalosis. Thought must be given to developing solutions with varying bicarbonate concentrations for various treatment modalities.

MeSH terms

  • Alkalosis / etiology*
  • Bicarbonates
  • Child
  • Child, Preschool
  • Female
  • Glucans
  • Glucose
  • Hemodialysis Solutions / adverse effects*
  • Hemodialysis Solutions / chemistry
  • Humans
  • Icodextrin
  • Infant
  • Lactic Acid
  • Male
  • Peritoneal Dialysis / adverse effects
  • Peritoneal Dialysis / methods*

Substances

  • Bicarbonates
  • Glucans
  • Hemodialysis Solutions
  • Icodextrin
  • Lactic Acid
  • Glucose