Korean Journal of Nephrology 1997;16(3):544-550.

간경변증이 동반된 지속성외래복막투석 (CAPD) 환자에서의 혈청 유산염 농도

이현숙 , 강재영 , 양원석 , 김순배 , 이상구 , 박정식 , 강덕희 , 윤견일

Abstract

Lactate is the most commonly used buffer in CAPD. The buffering effect of lactate is accomplished by its complete rnetabolism in liver and kidney. In patients with hepatic disease the rate of metabolism may be lower with a consequent inc- rease in plasma lactate levels. Plasrna lactate levels, however, have not been measured in CAPD patients. This study was performed to evaluate the plasma lactate levels and acid-base status in CAPD patients with liver cirrhosis. The concentrations of arterial L-lactate, pH, bi- carbonate and venous total Coz were measured in 6 CAPD patients with LC, 36 CAPD patients without liver disease and 17 LC patients. All CAPD patients used commercially available dialysate containing 4hnmol/L lactate(D,L-racemic solution). Arterial lactate levels were 4.19mmol/L in CAPD patients with LC, 1.43mmol/L in CAPD patients and 1.94mmol/L in LC patients(p<0.05). Arterial pH were not different among subgroups. Arterial bicarbonate concentrations were 20.5meq/L in CAPD patients with LC, 24.2meq/L in CAPD patients and 24.4meq/ L in LC patients. Venous total CO2 levels were 21.4, 24.7 and 23.4meq/L, respectively. Anion gap were 13.1, 9.4 and 8.1, respectively. From our results and possible toxicity of elevated lactate levels, lactate-containing PD solutions should be used carefully to treat CAPD patients with LC.