Sodium D, L-lactate is commonly used as an acidosis correcting agent of parenteral solutions for fluid therapy. It has, however, optical isomer. As it's D-configuration is nonphysiological, disadvantages such as a slower rate of metabolism and a different metabolic pathway from L-configuration are reported. Therefore D-configuration makes its usefulness as well as its safety questionable, especially in infants, as they can metabolize D-configuration a little. In this study, a comparison were made between a peritoneal dialysate containing L-configuration only (L-solution) and the conventional one containing L- and D-configurations (50: 50) (D, L-solution). The lactate levels in blood and dialysate, alkalizating effect, etc., were examined applying alternately to 2 cases of chronic renal failure on intermittent peritoneal dialysis. With L-solution, the D- and L-lactate levels in blood remained unchanged, while an increase of D-lactate level in blood was observed after dialysis with D, L-solution. The former solution had a tendency to have more improvement in B. E., although statistically significant differences were not observed. Sodium L-lactate seems much favorable as an acidosis correcting agent since endogenous lactic acid is L-configuration. More favorable effects is expected in the case of abnormal carbohydrate metabolism or hepatic failures.
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