Bicarbonate/lactate-based peritoneal dialysis solution increases cancer antigen 125 and decreases hyaluronic acid levels

Kidney Int. 2001 Apr;59(4):1529-38. doi: 10.1046/j.1523-1755.2001.0590041529.x.


Background: In a randomized, controlled trial comparing a pH neutral, bicarbonate/lactate (B/L)-buffered PD solution to conventional acidic, lactate-buffered solution (C), the overnight dialysate levels of markers of inflammation/wound healing [hyaluronic acid (HA)], mesothelial cell mass/membrane integrity [cancer antigen 125 (CA125)], and fibrosis [transforming growth factor-beta1 (TGF-beta1) and procollagen I peptides (PICP)] were assessed over a six-month treatment period.

Methods: One hundred six patients were randomized (2:1) to either the B/L group or C group. Overnight effluents were collected at entry into the study (time = 0 all patients on control solution) and then at three and six months after randomization. Aliquots were filtered, stored frozen, and assayed for HA, CA125, TGF-beta1, and PICP. Differences between groups were assessed by repeated-measures analysis of variance for unbalanced data using the SAS procedure MIXED.

Results: In patients treated with B/L, there was a significant (P = 0.03) increase in CA125 after six months compared with time = 0 (19.76 +/- 11.8 vs. 24.4 +/- 13.8 U/mL; mean +/- SD; N = 51). In the same group of patients, HA levels were significantly decreased at both three and six months in the B/L-treated group (time = 0, 336.0 +/- 195.2; time = 3 months, 250.6 +/- 167.6; and time = 6 months, 290.5 +/- 224.6 ng/mL; mean +/- SD; P = 0.006, N = 47 and P = 0.003, N = 48, respectively). No significant changes in CA125 or HA levels were observed in the control group. There were no significant changes observed in the levels of PICP or TGF-beta1 in the B/L or C group over the six-month treatment period.

Conclusions: These results suggest that continuous therapy with the B/L solutions modulates the levels of putative markers of peritoneal membrane integrity and inflammation. In the long term, this may positively impact the peritoneal membrane, increasing its life as a dialyzing organ.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bicarbonates / administration & dosage*
  • Bicarbonates / therapeutic use
  • CA-125 Antigen / metabolism
  • Dialysis Solutions / chemistry
  • Dialysis Solutions / therapeutic use*
  • Female
  • Humans
  • Hyaluronic Acid / metabolism
  • Lactates / administration & dosage*
  • Lactates / therapeutic use
  • Male
  • Middle Aged
  • Peptide Fragments / metabolism
  • Peritoneal Dialysis*
  • Procollagen / metabolism
  • Time Factors
  • Transforming Growth Factor beta / metabolism
  • Transforming Growth Factor beta1


  • Bicarbonates
  • CA-125 Antigen
  • Dialysis Solutions
  • Lactates
  • Peptide Fragments
  • Procollagen
  • TGFB1 protein, human
  • Transforming Growth Factor beta
  • Transforming Growth Factor beta1
  • procollagen type I carboxy terminal peptide
  • Hyaluronic Acid