calcium chloride + glucose, anhydrous + glucose monohydrate + magnesium chloride + sodium chloride + sodium lactate: clinical use

Prescribing considerations

• Select glucose concentration and osmolarity according to fluid-removal requirements, using the lowest osmolarity consistent with the clinical objective.
• Assess abdominal integrity, peritoneal function, respiratory disease, hydration, nutritional losses, glycaemic control and lactic-acidosis risk.
• Use caution with abdominal wall or intra-abdominal disease, hernia, stomas, inflammatory or ischaemic bowel disease, recent aortic grafting and severe pulmonary disease.
• Check additive compatibility and maintain strict aseptic technique.

Contraindications and cautions

• Hypersensitivity to an active substance or excipient.
• Pre-existing severe lactic acidosis.
• Uncorrectable mechanical defects preventing effective peritoneal dialysis or increasing infection risk.
• Documented loss of peritoneal function or extensive adhesions compromising function.

Monitoring

• Fluid balance, body weight, blood pressure and signs of over- or underhydration.
• Drained fluid, catheter site and symptoms of peritonitis.
• Bicarbonate, potassium, magnesium, calcium, phosphate and sodium as clinically appropriate.
• Blood glucose in diabetes; review glucose-lowering treatment when dialysis changes.
• Parathyroid hormone, lipid and haematological parameters.
• Protein, amino-acid and water-soluble-vitamin losses where clinically relevant.

Clinical pharmacology

Solutes cross the peritoneal membrane by diffusion. Glucose makes the solution hyperosmolar and drives ultrafiltration; absorbed glucose follows normal metabolic pathways. Lactate is converted towards bicarbonate, supporting acid–base correction.

Formulation and product differences

• The selected product is a clear, colourless, low-calcium, glucose-based, lactate-buffered electrolyte solution without potassium.
• Products are available with different glucose concentrations; higher concentrations create greater osmotic water removal.
• Bag configurations vary, and some include an integral drainage bag. Each bag is for single use.