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Nephrology Dialysis Transplantation, Vol 12, Issue 5 981-983, Copyright © 1997 by Oxford University Press

ORIGINAL ARTICLES

High serum D-lactate in patients on continuous ambulatory peritoneal dialysis

Y Anderson, N Curtis, J Hobbs, C Thompson, C Winearls, G Radda, K Clarke and P Altmann
Department of Biochemistry, University of Oxford, Oxford, UK; Oxford Renal Unit, The Churchill Hospital, Headington, Oxford, UK; Correspondence to YS Anderson, Department of Biochemistry, University of Oxford, South Parks Road, Oxford OX1 3QU, UK

Background. As abnormally high serum D-lactate levels may cause nephrological impairment, we determined whether patients undergoing continuous ambulatory peritoneal dialysis (CAPD) with lactate-containing fluids have increased serum D-lactate concentrations. Methods. D- and L-lactate concentrations were determined in peritoneal dialysis fluids and in serum from control subjects (n = 10), haemodialysis patients (n = 10), and CAPD patients (n = 30) before and after 1 h of dialysis. Results. We found the median D-lactate concentration in Dianeal CAPD fluid to be 26 mM (range 19-27), whereas it was less than 0.5 mM in DPCA2 fluid. Control, haemodialysis, and CAPD (DPCA2) patient median serum D-lactate concentrations were below 0.07 mM. However, CAPD (Dianeal)_patient serum D-lactate concentrations were 4-fold higher than controls (P <0.0001), at 0.28 mM, an hour after instillation of D-lactate-containing fluid. Three patients, whose serum D-lactate averaged 0.59 mM, were found to have D-lactate concentrations at 0.22 mM after overnight cessation of dialysis. Conclusion. We conclude that CAPD with D-lactate-containing fluids raises serum D-lactate to abnormal levels. Keywords: Continuous ambulatory peritoneal dialysis (CAPD); D-lactate; haemodialysis; D-lactate; renal failure
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