Peritoneal function in clinical practice: the importance of follow-up and its measurement in patients. Recommendations for patient information and measurement of peritoneal function

Abstract

A review is given on peritoneal function, especially ultrafiltration and ultrafiltration failure followed by recommendations on how to translate pathophysiology into clinical practice. The subsequent consequences for management of peritoneal membrane function and for patient information are also included.

The impact of dialysis solution biocompatibility on ultrafiltration and on free water transport in rats

“…These results could be explained by either an acid-base effect, i.e., changes in phosphate availability for exchange, for example changes in phosphate cellular shift. These results may also be explained by changes in various factors that have an impact on the peritoneal dialysis membrane when exposed to a neutral, pure bicarbonate, physiologically more biocompatible dialysis fluid with a low concentration of GDPs, i.e., BicaVera®, compared to a conventional dialysis fluid, i.e., acidic lactate with a high concentration of GDPs, for example, the peritoneal surface area, the pressure gradient, the capillary perfusion, the endothelial pore function, and the peritoneal membrane absorption [16][17][18][19][20]. Nevertheless, in children, phosphate dialytic elimination was slightly reduced with bicarbonate fluid [15].…”

“…These results cannot be entirely explained by changes in glucose transport, i.e., the crystalloid osmotic pressure, and may depend on other factors such as changes in the hydrostatic capillary pressure gradient. The vasodilatatory properties of the conventional lactate-based PDF are well documented [1,5,15,[17][18][19][20][21][22], in part due to their higher GDP concentration [3]. These vasoactive properties lead to hyperperfusion of the peritoneum, resulting in an initial increase in hydrostatic capillary pressure impacting on capillary function, potentially enhancing the ultrafiltration volume [17,18].…”

Value of accelerated peritoneal examination time in pediatric nocturnal intermittent peritoneal dialysis

“…But on the contrary, Rocco, et al describes good small molecule clearance in high peritoneal membrane transporters [20]. Hence from this study, it is possible that by shortening the dwell time, CrCl is significantly affected and thus the patient with high/high average transporters may need a day dwell with icodextrin or shift to adapted peritoneal dialysis to balance between UF and clearance [3,[21][22][23][24][25][26][27][28]]. …”

Matrix Metalloproteinases Cause Peritoneal Injury in Peritoneal Dialysis

“…These results suggest that MMP-2 may be a more useful marker of peritoneal injury with increased solute transport than other MMPs or TIMPs. IL-6, hyaluronic acid, and cancer antigen (CA) 125 are often used as markers of peritoneal injury [2,29]. In the study by Kaku et al, although the sample size was not sufficient for a statistically significant relationship, the correlation coefficient between the peritoneal solute transport rate and MMP-2 levels was higher than that for IL-6, hyaluronic acid, or CA125 [15].…”