The Cytotoxicity of Continuous Ambulatory Peritoneal Dialysis Solutions with Different Bicarbonate/Lactate Ratios

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 116-118 ◽  
Author(s):  
Hans Thalsgård Schambye ◽  
Fritz Bangsgaard Pedersen ◽  
Hanne Knoldsborg Christensen ◽  
Henrik Berthelsen ◽  
Palle Wang
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Culture Medium ◽  
Lactate Concentration ◽  
Cellular Function ◽  
Bicarbonate Concentration ◽  
Cytotoxic Effects ◽  
Migratory Capacity ◽  
Normal Human ◽  
Dialysis Solutions

Five different bicarbonate-based continuous ambulatory peritoneal dialysis (CAPD) solutions (pH: 7.0-7.4; bicarbonate: 10-27 mM; lactate: 20.8–0.7 mM) were produced in order to examine the cytotoxic effects of the different compositions. The migratory capacity of normal human polymorphonuclear (PMN) granulocytes after exposure to the solutions was used as a cytotoxicity assay. All the tested solutions reduced cellular function compared to a standard cell culture medium, but considerable differences between the solutions were observed. The optimal Conditions for the PMN migration were at a pH of 7.0 and at bicarbonate and lactate concentrations of 20 mM and 12.5 mM, respectively. Bicarbonate concentrations of more than 25 mM were associated with reduced cellular function as were lactate concentrations of more than 15 mM. The most advantageous CAPD solution regarding cytotoxicity towards normal human PMN's is a combination of a lactate and bicarbonate-based solution, which has a bicarbonate concentration of approximately 20 mM, a lactate concentration of 12.5 mM, and a pH of approximately 7.2.

Continuous Ambulatory Peritoneal Dialysis (CAPD) of Children with Amino Acid Solutions: Technical and Metabolic Aspects

1990 ◽  
Vol 10 (3) ◽  
pp. 215-220 ◽  
Author(s):  
Alberto Canepa ◽  
Francesco Perfumo ◽  
Alba Carrea ◽  
Maria Teresa Piccardo ◽  
Maria Rosa Ciardi ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Plasma Concentration ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Acid Solutions ◽  
Glucose Load ◽  
Protein Meal ◽  
Dialysis Solution ◽  
Basal Plasma ◽  
Amino Acid Solutions ◽  
Dialysis Solutions

The changes in plasma and dialysate amino acids (AA) in 7 continuous ambulatory peritoneal dialysis (CAPD) children after dialysis with a 1% AA solution were compared with a glucose-containing solution. During the AA exchange, the plasma levels of individual AA reached their peaks after 1 h, with their percentage increments significantly correlated (p < 0.001) with the ratio of the amount of AA in the bag to the basal plasma concentration. The plasma concentration of methionine, valine, phenylalanine, and isoleucine remained higher than the basal value at 4 h. The amount of AA absorbed was 66% after 1 h, and 86% after 4 h and 6 h, corresponding to 2574 ± 253 μmollkg body wt. During glucose-dialysis (1.36%), levels of histidine, methionine, valine, phenilal-anine, and isoleucine were significantly decreased in plasma after 1 h, and stayed low throughout the dialysis period. The loss of AA with the peritoneal effluent was 116 ± 69 μmol/kg/body wt. From this study, it seems that using an AA dialysis solution, with 1 exchange per day, might limit the daily glucose load and compensate for AA losses by supplying an extra amount of AA and by reducing the loss of other AA not contained in dialysis solutions. The AA pattern in plasma following AA-dialysis resembles that observed after a protein meal, with no signs of persistently high, nonphysiological levels.

Effects of Amino Acid Dialysis Solution on the Nutrition of Continuous Ambulatory Peritoneal Dialysis Patients

1999 ◽  
Vol 19 (5) ◽  
pp. 462-470 ◽  
Author(s):  
Alicja E. Grzegorzewska ◽  
Irena Mariak ◽  
Agnieszka Dobrowolska–Zachwieja ◽  
Lech Szajdak
Keyword(s):  
Amino Acids ◽  
Peritoneal Dialysis ◽  
Amino Acid ◽  
Nutritional Status ◽  
Body Mass ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Nitrogen Balance ◽  
Control Group ◽  
Dialysis Solution ◽  
Dialysis Solutions

Objective To evaluate the influence of 1.1% amino acid dialysis solution (AADS) on parameters of nutrition in continuous ambulatory peritoneal dialysis (CAPD) patients. Study Design Studies were performed in 8 men, using AADS for the overnight exchange. Before starting AADS, food intake, nutritional status, and laboratory indices were evaluated and compared to the respective parameters obtained after 3 and 6 months of treatment with AADS, as well as after 3 months of AADS withdrawal. With the start of AADS, doses of antacids were increased and modified during AADS administration; the modified doses were continued through 3 months after cessation of AADS. Another group of CAPD patients using standard dialysis solutions served as controls. In these patients the same parameters were evaluated four times at 3-month intervals. Results Administration of AADS resulted in: (1) 91% absorption of amino acids and improvement of serum amino acid pattern; (2) no change in nutritional intake during the treatment, but after the 3 months of AADS therapy, levels of nutrient intake were lower than those 3 months after withdrawal of AADS with correction of metabolic acidosis; (3) no change in indices of nutritional status, but 3 months after AADS discontinuation, total body weight, lean body mass, and body mass index were significantly higher than those shown after 3 months of treatment; (4) an increase in hemoglobin concentration, hematocrit, BUN, and blood H+. The examined parameters were not significantly changed in patients treated for 9 months with standard dialysis solutions exclusively. The values of nitrogen balance obtained during AADS administration and after 3 months of AADS withdrawal were significantly higher than those obtained in the respective periods in the control group. The blood pH, pCO2, and HCO3– in the last period of the study were higher in the AADS group than in the control group. Conclusion In relatively well-nourished CAPD patients, overnight AADS administration results in increased serum concentration of amino acids without changes in other nutritional parameters. The use of AADS should be associated with increased doses of antacid medication, which abolishes the metabolic effects of acidosis that develop during AADS administration and facilitates positive nitrogen balance.

Continuous ambulatory peritoneal dialysis using self-made, ultrafiltration-sterilized, L-lactate-based dialysis solution

1994 ◽  
Vol 17 (9) ◽  
pp. 488-491 ◽  
Author(s):  
T.S. Ing ◽  
A.W. Yu ◽  
B. Agrawal ◽  
P.K. Tiwari ◽  
A.P. McShane ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
End Stage Renal Failure ◽  
Plastic Bags ◽  
Dialysis Solution ◽  
Sterile Plastic ◽  
End Stage ◽  
Dialysis Solutions

Continuous ambulatory peritoneal dialysis was successfully carried out in 6 end-stage renal failure patients using self-made, ultrafiltration-sterilized dialysis solutions. A Y-set was used to deliver the above solutions to sterile plastic bags.

Compatibility of Cefazolin and Gentamicin in Peritoneal Dialysis Solutions

1986 ◽  
Vol 20 (9) ◽  
pp. 697-700 ◽  
Author(s):  
Paul C. Walker ◽  
Ralph E. Kaufmann ◽  
Neil Massoud
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Statistical Significance ◽  
Drug Assay ◽  
Dialysis Solution ◽  
Gentamicin Concentration ◽  
Peritoneal Dialysis Solution ◽  
Concentration Changes ◽  
Dialysis Solutions ◽  
Peritoneal Dialysis Solutions

The compatibility of cefazolin and gentamicin in fluid commonly used for continuous ambulatory peritoneal dialysis (CAPD) was studied. Five admixtures containing cefazolin (75 mg/L and 150 mg/L) and gentamicin (8 mg/L), alone and in combination, were prepared in 1.5% dextrose peritoneal dialysis solution. Solutions were stored for 48 hours at 4°C, 26°C, and 37°C; aliquots for drug assay were obained at 0, 4, 8, 24, and 48 hours. HPLC and immunofluorescent assays were used to determine cefazolin and gentamicin concentrations, respectively. The cefazolin and gentamicin concentration changes over the study period did not reach statistical significance. Maximal cefazolin and gentamicin losses (12 and 7 percent of the initial concentrations, respectively) were observed at 48 hours in solutions stored at 37°C. No significant differences in concentration changes were observed between combination solutions and solutions containing either cefazolin or gentamicin alone. Cefazolin and gentamicin, alone or in combination, are compatible for at least 48 hours in CAPD solutions.

Changes in Acid-Base Balance during Peritoneal Dialysis with Fluid Containing Lactate Ions

1970 ◽  
Vol 39 (1) ◽  
pp. 51-60 ◽  
Author(s):  
S. R. Dixon ◽  
W. I. McKean ◽  
J. E. Pryor ◽  
R. O. H. Irvine
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Metabolic Acidosis ◽  
Blood Lactate ◽  
Peritoneal Cavity ◽  
Lactate Concentration ◽  
Blood Lactate Concentration ◽  
Bicarbonate Concentration ◽  
Bicarbonate Ions ◽  
Arterial Blood

1. Twenty-three peritoneal dialyses with fluid containing 45 mEq lactate per litre were carried out on six patients with acute or chronic renal failure. During dialysis arterial blood pH and base excess rose. 2. The lactate ions were rapidly and almost completely absorbed from the fluid in the peritoneal cavity. Blood lactate concentration rose, but in patients with adequate liver function it did not exceed the normal range. One patient with poor hepatic function and renal failure showed abnormally high blood lactate levels after peritoneal dialysis, but metabolic acidosis was still corrected. 3. The concentration of bicarbonate ions in the fluid drained from the peritoneal cavity rose as the dialysis progressed. A significant positive correlation was found between the arterial blood bicarbonate concentration and the bicarbonate concentration in the fluid drained from the peritoneal cavity. 4. If the lactate ions absorbed from the peritoneal cavity had not been metabolized the loss of bicarbonate ions in the fluid drained from the peritoneal cavity would have increased the metabolic acidosis.

scholarly journals HES as an Osmotic Agent for Continuous Ambulatory Peritoneal Dialysis Solutions

Nephron ◽  
1992 ◽  
Vol 61 (1) ◽  
pp. 120-120
Author(s):  
N. Gretz ◽  
A. Hocker ◽  
J.J. Lasserre ◽  
M. Strauch
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Osmotic Agent ◽  
Dialysis Solutions ◽  
Peritoneal Dialysis Solutions

Cytotoxicity of Continuous Ambulatory Peritoneal Dialysis (CAPD) Solutions. A Biocompatibility Study Involving Human Polymorphonuclear Granulocytes Rather than Laboratory Animals

1992 ◽  
Vol 20 (2) ◽  
pp. 275-279
Author(s):  
Hans T. Schambye ◽  
Fritz B. Pedersen ◽  
Palle Wang
Keyword(s):  
Peritoneal Dialysis ◽  
Culture Medium ◽  
Cell Function ◽  
Control Level ◽  
Low Ph ◽  
Laboratory Animals ◽  
Cell Culture Medium ◽  
Polymorphonuclear Granulocytes ◽  
Dialysis Solutions ◽  
Biocompatibility Study

Continuous amulatory peritoneal dialysis (CAPD) is a well-established treatment for renal failure. Peritonitis is the most important and serious complication to CAPD. The predisposition of patients to contract peritonitis has been attributed to functional impairment of immunoactive cells in the peritoneal cavity due to cytotoxicity of the dialysis solutions used. A model for biocompatibility studies of CAPD solutions is presented, in which the migration and phagocytotic capacity of normal isolated human polymorphonuclear granulocytes (PMN) were examined after exposure to the test solutions. The methods proved to be highly reproducible. The commercially-available lactate-based CAPD solutions tested reduced PMN function, mostly due to their low pH. Cell function was improved by elevation of pH, but not to the control level, when the cells were exposed to RPMI — a standard cell culture medium. A new bicarbonate-based CAPD solution proved to be less cytotoxic than the lactate-based ones, and is at present undergoing clinical evaluation.

Scanning Electron Microscopy of Staphylococcus Epidermidis Adherence to Continuous Ambulatory Peritoneal Dialysis Catheters

1985 ◽  
Vol 43 ◽  
pp. 520-521
Author(s):  
William J. Lamoreaux ◽  
David L. Smalley ◽  
Larry M. Baddour ◽  
Alfred P. Kraus
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Staphylococcus Epidermidis ◽  
Sterile Saline ◽  
Intravascular Devices ◽  
Capd Patient ◽  
Scanning Electron

Infections associated with the use of intravascular devices have been documented and have been reported to be related to duration of catheter usage. Recently, Eaton et al. reported that Staphylococcus epidermidis may attach to silastic catheters used in continuous ambulatory peritoneal dialysis (CAPD) treatment. The following study presents findings using scanning electron microscopy (SEM) of S. epidermidis adherence to silastic catheters in an in vitro model. In addition, sections of polyvinyl chloride (PVC) dialysis bags were also evaluated by SEM.The S. epidermidis strain RP62A which had been obtained in a previous outbreak of coagulase-negative staphylococcal sepsis at local hospitals was used in these experiments. The strain produced surface slime on exposure to glucose, whereas a nonadherent variant RP62A-NA, which was also used in these studies, failed to produce slime. Strains were grown overnight on blood agar plates at 37°C, harvested from the surface and resuspended in sterile saline (0.85%), centrifuged (3,000 rpm for 10 minutes) and then washed twice in 0.1 M phosphate-buffered saline at pH 7.0. Organisms were resuspended at a concentration of ca. 106 CFU/ml in: a) sterile unused dianeal at 4.25% dextrose, b) sterile unused dianeal at 1.5% dextrose, c) sterile used dialysate previously containing 4.25% dextrose taken from a CAPD patient, and d) sterile used dialysate previously containing 1.5% dextrose taken from a CAPD patient.

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