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Nephrol Dial Transplant (1989) 4: 800-804
© 1989 European Renal Association-European Dialysis and Transplant Association

research-article

The Effect of Lactate-Buffered Solutions on the Acid-Base Status of Patients with Renal Failure

A. Davenport, E. J. Will and A. M. Davison

Department of Renal Medicine, St James's University Hospital Leeds, UK

Correspondence and offprint requests to: Correspondence and offprint requests to: Dr A. Davenport, Department of Renal Medicine, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK

We investigated the effect of an exogenous lactate load given during intermittent machine haemofiltration to three groups of patients with renal failure: those with dialysis-dependent end-stage renal failure (6 patients) and those with either acute renal (8 patients) and/or acute hepatorenal failure (6 patients). As expected, the hepatorenal group exhibited the greatest degree of hyperlactataemia, and this was associated with the development of a metabolic acidosis. There were correlations between the maximum blood lactate measured during treatment and the increase in arterial hydrogen ion concentration (r=;0.76, P<0.001), and between the decrease in serum bicarbonate (r=0.89, P< 0.001) and the mean arterial blood pressure prior to treatment (r= –0.57, P = 0.003). This suggests that hyperlactataemia is not as benign as previously thought and that lactate-buffered fluids should be used with care in patients with hepatorenal failure and cardiovascular instability.

Keywords: Acid-base; Renal failure; Haemofiltration; Lactate


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Continuous veno–venous haemodialysis with a novel bicarbonate dialysis solution: prospective cross-over comparison with a lactate buffered solution
Nephrol. Dial. Transplant., October 1, 1999; 14(10): 2387 - 2391.
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