La conversión a líquidos de diálisis peritoneal con bicarbonato puede afectar la volemia de los pacientes

Abstract

The aim was to assess the repercussion of changing the buffer used in peritoneal dialysis fluids, especially on parameters related to blood volume and on the quality of the dialysis. Material y methodsA 6-month retrospective descriptive study was carried out. The sample was composed of 18 patients. All the variables of the digital medical history for the last quarter of 2011 were compiled when the patients used fluids with lactate, and for the last three months when they used solutions with bicarbonate.The analysis was carried out suing the IBM SPSS Statistics 19.0 statistical package. Results: The sample comprised 18 patients, 61.1% of which were men. The mean age was 72.5 + 1.43 years. 55.6% were on continuous ambulatory peritoneal dialysis and 44.4% on automatic dialysis. We compared residual renal function and the variables involved in changes in blood volume. Although diuresis, ultrafiltration and residual renal function decreased, only the last of these being signifi cant (p=0.031) and weight increased, it was possible to achieve it by increasing the number of exchanges in 27.8% of cases or by increasing the glucose concentration also in 27.8%. It was found that the change of fluid did not affect the peritoneal or renal dialysis dose. Peritoneal transport was also unaffected. Conclusion: After changing solutions to bicarbonate, our patients have shown less ultrafi ltration and diuresis and an increase in weight, which together with the increase in glucose concentrations in fi ve cases and in the number of exchanges in another fi ve cases, lead us to evaluate more closely the parameters related to blood volume in patients who use these new solutions.