Bohler J, Dobos G, Sach M, Passlick-Deetjen M, Schollmeyer P
Bacteria grow better if pH of CAPD solutions is elevated
from 5.0 to 6.4, offsetting improvement in neutrophil phagocytosis
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:507 1995
Much controversy surrounds the composition of the optimal, most biocompatible
peritoneal dialysis
fluid. Glucose based osmotic agents in commercial solutions have to be kept
at an acid pH when
autoclaved to prevent caramelization. This acid pH also has the undesirable
effect of inhibiting
leukocyte phagocytosis or bacteria. In this presentation the authors show
that if the pH of
dialysis solution is adjusted to near neutral, there is increased bacterial
growth.
Comment: This potentially deleterious effect of near neutral pH
dialysate may be offset by
the increase in phagocytic activity of leukocytes kept in PD solutions of
near neutral pH vs. acidic
pH, especially given the fact that the speed of phagocytosis far exceeds the
speed of bacterial multiplication.
(Vas)
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Am Soc Nephrol
Basic peritoneal dialysis :
Peritonitis and exit-site infection