Influence of exchange volume and dialysate flow rate on solute clearance in peritoneal dialysis

Robson, M; Oreopoulos, D. G.; Izatt, S.; Ogilvie, Raymond; Rapoport, A.; Deveber, G.A.

doi:10.1038/ki.1978.153

Cited by 48 publications

(19 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While earlier papers have described significant losses of protein in patients undergoing acute or chronic inter mittent peritoneal dialysis varying from 25 to more than 200 g/dialysis [5][6][7], more recent papers have indicated the amount of protein loss to approximate 10 g/day, depending on the conditions of dialysis [8][9][10]. The various factors that affect the amount of protein loss include dialysate volume (2 liter exchanges result in higher protein loss than I liter exchanges), flow rate, and the concentration of dex trose [7,10].…”

Section: Discussionmentioning

confidence: 99%

Reappraisal of Protein Losses in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Katirtzoglou¹,

Oreopoulos²,

Husdan³

et al. 1980

Nephron

Self Cite

View full text Add to dashboard Cite

Dialysate effluent protein content was measured in 22 patients undergoing continuous ambulatory peritoneal dialysis (9 with and 13 without previous peritonitis). The average amount of protein in those patients without peritonitis was 1.3 g/2 liters exchanged over a 6-hour period, while that of patients with previous peritonitis was 2.6 g/ 2 liters exchanged over the same period. 71 % of protein found in the dialysate of 2 patients was albumin. Despite the difference in the amount of protein lost between those without and those with peritonitis, there was no significant difference in their mean serum albumin levels (3.2 and 3.4 g%, respectively) which were only slightly below the normal range. The previously reported high protein losses in patients undergoing CAPD are probably the result of frequent episodes of peritonitis and a higher number (five) of daily exchanges.

show abstract

Section: Discussionmentioning

confidence: 99%

Reappraisal of Protein Losses in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Katirtzoglou¹,

Oreopoulos²,

Husdan³

et al. 1980

Nephron

Self Cite

View full text Add to dashboard Cite

show abstract

“…In relation to uncharged materials, these investigations have shown a relative resistance to electrolyte transfer from the peritoneum to the dialysis fluid (Nolph, 1979). These explorations have shown, for example, that potassium, which has a diffusion coefficient 1.35 times that for urea, enters the dialysate from the blood less well than urea rather than better, as would be expected from their diffusion coefficients (Boen, 1961;Robson et al, 1978). The finding of a relative resistance to electrolyte transfer in the eel rete is therefore not unique; it is also present at the peritoneal surface.…”

Section: The Peritoneummentioning

confidence: 99%

Passage of ions and dextran molecules across the rete mirabile of the eel. The effects of charge.

Rasio¹,

Goresky²

1985

Circulation Research

View full text Add to dashboard Cite

SUMMARY. The countercurrent-perfused rete mirabile of the eel is a preparation in which capillary permeability values can be determined accurately in broadscale fashion. To provide insight into charge effects on transendothelial passage, the permeability values of small inorganic cations (labeled sodium and rubidium, and stable potassium) and anions (labeled chloride, iodide, sulfate, and ferrocyanide) were compared to those expected for neutral solutes with approximately matched diffusion coefficients, and that of a neutral dextran fraction was compared to that of a negatively charged dextran sulfate with a similar diffusion coefficient. In the small ion experiments, the labeled iodide values were unexpectedly high, apparently due to the contamination of the labeled iodide solution with IJ~. The permeabilities of the rest of the ions clustered at a level about 0.5 of the values which would have been expected for neutral solutes with similar diffusion coefficients. The decrement was interpreted to reflect the presence, of both positive and negative charges along the transendothelial pathway, which effectively decrease the dimensions of the limiting part of the pathway for the charged microions relative to that accessible to comparable nonelectrolytes. The larger negatively charged dextran sulfate was also reduced in its passage, in comparison with its matching neutral dextran; this was taken to indicate the presence of a larger1 scale average net negative charge along its pathway. The data indicate the presence of a staggering of positive and negative charges along the transendothelial pathway accessible to the microions, and a net negative charge in the more restricted part of the pathway available to the dextrans. (CircRes 56: 74-83, 1985) BLOOD capillary permeability to small ions has long been known to be a minute fraction of that for water, irrespective of the methods used and tissues investigated. The data have been interpreted as indicating the presence of differing paths for the passage of ions and water across the endothelial wall, the mechanism for the transfer of each usually being thought to be passive [except in certain special areas, such as the tight capillaries of the central nervous system and the eye, where evidence for some active transport of sodium and potassium ions has been presented (Bradbury and Stulcova, 1970;Eisenberg and Suddith, 1979;Betz and Goldstein, 1980)]. It has been expected that appropriately designed studies with ions and charged molecules would provide information concerning the effects of local fixed charges, if these are present in the regions where inorganic ions and other charged materials traverse the capillary wall.Few capillary beds have been thoroughly examined from this point of view. The glomerular apparatus of the kidney constitutes the one exception. Studies of glomerular filtration of moderately large molecules with different charges and comparable molecular size have provided evidence for a charge effect in this structure. These studies indicate that, altho...

show abstract

“…The development of reliable chronic access to the peritoneal cavity using indwelling catheters [1,2], and the development of treatment sched ules which simplify the procedure for intermittent over night treatment [3][4][5][6][7][8][9][10][11][12] or continuous treatment in the ambulatory patient [13][14][15] have resulted in wider applica tion of chronic PD to the home-based, self-care setting. However, increased utilization of this form of treatment necessitates clearer definition in large numbers of pa tients of the incidence and types of complications arising directly from the devices and treatment schedules being used.…”

mentioning

confidence: 99%

Chronic Peritoneal Dialysis: Mechanical and Infectious Complications

Swartz¹

1985

Nephron

View full text Add to dashboard Cite

The present report summarizes the mechanical and infectious complications attributable to the devices and procedures used for chronic peritoneal dialysis (PD), comparing the type and frequency of such complications in contemporaneous groups of patients undergoing continuous ambulatory PD (CAPD) or intermittent PD (IPD). Mechanical complications related directly to the catheter and its placement proved to be equally frequent during CAPD and IPD. On the other hand, mechanical complications related to increased intraperitoneal pressure were more frequent during CAPD. In most instances mechanical complication can be managed without permanent interruption of chronic PD. Peritonitis occurs more frequently during CAPD (1.6 episodes per patient-year) than during IPD (0.4 episodes per patient-year), with a tendency to more frequent peritonitis among diabetics, children, patients with white blood cell abnormalities, patients with catheter cuff or tunnel inflammation, and during the 1st month of treatment. Medical therapy eradicates peritonitis and allows continuation of chronic PD with retention of the catheter in more than 90% of episodes, although special problems may be encountered with fungal, pseudomonal, and some coagulase-positive staphylococcal infections.

show abstract

Influence of exchange volume and dialysate flow rate on solute clearance in peritoneal dialysis

Cited by 48 publications

References 6 publications

Reappraisal of Protein Losses in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Reappraisal of Protein Losses in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Passage of ions and dextran molecules across the rete mirabile of the eel. The effects of charge.

Chronic Peritoneal Dialysis: Mechanical and Infectious Complications

Contact Info

Product

Resources

About