effect of bicarbonate dialysis on lactate/ pyruvate ration after minimal exercise in regular dialysis patients

Muscle handling of lactate is known to be impaired in regular dialysis treatment [RDT] patients on acetate hemodialysis [AHD].This study was undertaken to evaluate the late after effect of bicarbonate hemodialysis [BHD] on lactate/pyruvate [L/P] ratio as an indicator of anaerobic muscle metabolism following minimal exercise. It included five normal volunteers and eight patients on RDT.The latter was first tested on conventional AHD and again after ten sessions of BHD. Assessment was done three-four days after dialysis, just before the next session.All subjects were exercised by walking on a tread-mill at 0 grade, 5 km/hr for 10 min. BCN, serum creatinine, Ca, Kand blood lactate and pyruvate were determined before and immediately after exercise. Basal L/P ratio was more or less similar in the controls and uremic patients whether on AHD or BHD. L/P changes in the AHD group were highly significantly different from the controls immediately and 10 min post exercise. L/P changes in BHD did not differ from the controls and significantly differ from AHD immediately and 10 min post exercise. None of the parameters tested [BCN, serum creatinine, serum Ca and potassium] correlated with L/P ratio. It was concluded that BHD led to sustained correction of the disturbed aerobic muscle glycolysis seen in AHD