OBJECTIVE: To investigate the effects of an alternative peritoneal dialysis (PD) solution composed of a lactate/ bicarbonate (Lac/Bic) mixture (35/2 mmol/L), pH 7.0, on the appearance of cancer antigen 125 (CA125) in the peritoneal effluent. METHODS: Eight stable PD patients received a conventional solution containing 35 mmol/L lactate (Lac) for 11.9 +/- 9.2 months, and then changed to Lac/Bic for 3.1 +/- 0.7 months. Each patient acted as his/her own control. RESULTS: We studied 4 males and 4 females with a mean age of 57.4 +/- 16.8 years. Higher concentrations (U/mL) (p < 0.005) and appearance rates (AR) (U/min) (p < 0.05) of CA125 in the dialysate were observed with Lac/Bic than with Lac, during the sampling times of the peritoneal equilibration test (10, 120, and 240 minutes) and in the overnight effluent: CA125 5.7 versus 0.6, 18.9 versus 1.9, 29.7 versus 3.7, and 43.2 versus 5.5 U/mL; and AR 1177 versus 125,354 versus 36,297 versus 37, and 194 versus 26 U/min, respectively. Mean CA125 content in the 24-hour dialysate was 34.2 U/min (baseline) and 30.9 U/min (11.9 months) with Lac, and 207.9 U/min and 185 U/min after 1.6 and 3.1 months with Lac/Bic (p = 0.009). The intraperitoneal pH was more physiological during the dwell with the Lac/Bic solution. CONCLUSIONS: The CA125 levels in the peritoneal effluent with Lac/Bic are an effect of the solution's neutral pH, as other factors of the prescription were constant. The Lac/ Bic solution is more biocompatible than Lac, reflecting short- and medium-term changes in the mesothelial cells, whose clinical significance has not yet been determined.
Ascitic Fluid/chemistry , Ascitic Fluid/metabolism , CA-125 Antigen/analysis , Dialysis Solutions/chemistry , Epithelium/drug effects , Peritoneal Dialysis, Continuous Ambulatory/methods , Adult , Aged , Bicarbonates , Cross-Over Studies , Dialysis Solutions/pharmacology , Female , Humans , Hydrogen-Ion Concentration , Lactic Acid , Male , Middle Aged , Prospective Studies
Los objetivos del estudio fueron calcular el volumen residual peritoneal (VR) y analizar la relación de VR con el volumen de drenaje (VD).Se analizaron 22 determinaciones de VR, 12 a partir del drenaje de la noche y 10 a partir del drenaje del TER (Test de equilibrio peritoneal), realizado en nueve pacientes en diálisis peritoneal. Se calcula VR=Vinf*(S3-S2)/(SI-S3), donde Vinf es el volumen de infusión peritoneal, S1 las concentraciones de soluto en el drenaje nocturno o del TER, S2 en el baño "limpio" y S3 en el TEP=O (10 min) o infusión después del TEP. Se estudian los solutos urea, creatinina, glucosa, potasio y albúmina. Se analizan las concentraciones de solutos en las bolsas "limpias" de dializado del TEP y en la posterior, para detectar interferencias de la glucosa en las concentraciones de solutos.Los valores promedio de VR oscilaron entre 2,11 dl calculado para la creatinina y 3,41 dl para la albúmina, con una media de los cinco solutos de 2,66ñ1,09 dl. Se observa una correlación negativa entre VR y VD para la creatinina (r=0,49, p=0,019) y la media de los cinco solutos (r=0,53, p=0,020). Los valores de VD y los de VR para los cinco solutos no presentan diferencias entre los procedentes del inicio y del final del TEP. La distinta composición encontrada por otros autores de la bolsa de dializado del TER podría explicar las diferencias en los cálculos de VR respecto a los valores de este estudio. (AU)
Humans , Residual Volume/physiology , Peritoneal Dialysis/nursing , Peritoneal Dialysis/methods , Infusions, Parenteral , Urea/analysis , Creatinine/analysis , Glucose/analysis , Potassium/analysis , Albumins/analysis , Dialysis Solutions/chemistry , Peritoneal Cavity
