What substance is lactate in lactated Ringer's (LR) converted to by the liver?

Lactate in lactated Ringer's (LR) solution is primarily converted to bicarbonate by the liver through a process known as gluconeogenesis. When lactate is introduced into the body, it undergoes metabolism, particularly in the liver, where it is utilized in the Cori cycle. In this cycle, lactate is transformed into glucose, which can then be further metabolized. However, a significant aspect of lactate metabolism involves its conversion into bicarbonate, which plays a crucial role in maintaining acid-base balance within the body. This process helps to neutralize acidosis and buffer excess hydrogen ions, thereby stabilizing the pH levels in the blood. Thus, the conversion of lactate to bicarbonate is essential for ensuring proper metabolic function during states where lactate accumulation may occur, such as in shock or severe exercise.