Balance of non-metabolizable base in continuous peritoneal dialysis patients

Giuseppe Mioni, P. Messa, R. Mioni, G. Boscutti, A. Cruciatti, A. D'Angelo

Research output: Contribution to journalArticlepeer-review

Abstract

Acid generation and elimination processes compared to titratable non- metabolizable base (NaOH equivalents, NB) turnover in end-stage renal disease patients are examined in the light of the Law of electroneutrality. The application over 2 days of the whole-body NB balance technique to 18 patients undergoing continuous ambulatory peritoneal dialysis is evaluated. The results show that the mean rate of NB loss with peritoneal effluent (as bicarbonate and organic acid anions) exceeded the mean rate of NB gain with the dialysis fluid (as salts of lactic acid) by 24 (27), m (SD), mmol per 2 days. In spite of this, the bicarbonate and pH of the plasma remained stable and within normal limits. The concurrent mean rate of the intestinal NB absorption was about 61 (27) mmol per 2 days, as calculated from the whole body balances of the several electrolytes in the metabolic steady-state. This intestinal absorption was more than sufficient to restore the body base consumed in neutralizing endogenous acid generation: 37 (14), 2H2SO4 mmol per 2 days, the remaining NB being eliminated as bicarbonate and organic acid anions. The ample spectrum of plasma acid-base (A - B) values appears to some extent influenced by patient-related factors, such as the rate of drinking water intake and the set point deviation for organic acid turnover.

Original languageEnglish
Pages (from-to)23-32
Number of pages10
JournalScandinavian Journal of Clinical and Laboratory Investigation
Volume59
Issue number1
Publication statusPublished - 1999

Keywords

  • Acid-base status
  • Base balance
  • CAPD
  • Metabolizable acid

ASJC Scopus subject areas

  • Clinical Biochemistry

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