Bicarbonate-based peritoneal dialysis solution has less effect on ingestive behavior than lactate-based peritoneal dialysis solution

Abstract

Objective: The anorexia seen in peritoneal dialysis (PD) patients may be due partially to factors of dialysis solutions, such as pH and buffering agent. We tested the effects of different PD solutions in an experimental rat model for appetite. Design: The intraoral intake of a sucrose solution from an implanted intraoral cannula in freely moving male Wistar rats was used to evaluate appetite at 30 minutes and 120 minutes after intraperitoneal (IP) infusion of bicarbonate (25 mmol/L)/lactate (15 mmol/L)-based PD solution (P) and conventional lactate (40 mmol/L)-based PD solution (D) with different concentrations of glucose. We also tested different buffer solutions containing lactate and bicarbonate with different pH but with no glucose. Results: The IP infusion as such and the 30 mL volume did not inhibit appetite; however, appetite was significantly less inhibited by P than by D in the 1.36%, 2.27%, and 3.86% solutions (p < 0.05). Furthermore, intraoral intake was significantly higher in rats receiving IP solution with bicarbonate buffer (pH 7.4) than with lactate buffer (p < 0.05), whereas there was no significant difference in intraoral intake for lactate with pH 5.5, pH 6.6, or pH 7.4. Conclusions: The bicarbonate/lactate solution inhibited appetite less than the lactate solution; this was due partially to the use of bicarbonate. The results show possible benefit on appetite of reducing the lactate concentration in PD solutions. © 2009 International Society for Peritoneal Dialysis.