Successful peritoneal dialysis using 0.9% sodium chloride with modified M/6 sodium lactate solution and recycled catheters

Acute peritoneal dialysis (PD) was carried out in 8 patients with renal failure (5 acute, 3 chronic) using 2.076-litre cycles of 0.9% sodium chloride (1,250 ml) plus M/6 sodium lactate (600 ml) to which 5% dextrose (170 ml), 50% dextrose (40 ml) and 10% calcium gluconate (16 ml) were added. Two acute catheters were recycled amongst all the patients after sterilisation in 5% formaldehyde. In all 8 patients, there was progressive clinical and biochemical improvement during 12-88 cycles of PD performed over 0.5-35 days. 2 patients with acute renal failure recovered completely. Another patient had prostatectomy for obstruction and a 4th subsequently received a successful kidney transplant abroad. 3 patients died, 2 of them after discharge from hospital, and 1 defaulted from follow-up. Peritonitis occurred in 2 patients. No side effects attributable to the dialysis solution were observed. However, repeated chemical treatment resulted in catheter opacification and blockage of perforations, but reperforation using a sterile needle usually restored good drainage. In poor countries with limited dialysis facilities, the use of 0.9% sodium chloride with modified M/6 sodium lactate solutions for PD and reuse of acute PD catheters are effective, safe and cost-saving.