Peritoneal physiology-transport of solutes

Rippe, Bengt; Krediet, Raymond T.

doi:10.1007/978-94-011-0814-0_4

Cited by 80 publications

(97 citation statements)

References 183 publications

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“…Calculations were performed according to the three-pore concept of peritoneal membrane transport as described previously [10,11]. According to the three-pore model, small-solute sieving coefficients are close to F0.55, at least prior to peak time, when convection is of importance.…”

Section: Methodsmentioning

confidence: 99%

Enhanced Peritoneal Diffusion Capacity of <sup>51</sup>Cr-EDTA during the Initial Phase of Peritoneal Dialysis Dwells: Role of Vasodilatation, Dialysate ‘Stirring’, and of Interstitial Factors

Carlsson

Rippe²

1998

Blood Purif

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Mass transfer area coefficients (PS) to small solutes are usually markedly increased during the first 0–15 min of peritoneal dialysis (PD) dwells. This phenomenon may be due to, for example, initial arteriolar vasodilatation and, hence, recruitment of capillary surface area. Other possibilities are an initial discharge (or saturation) of solutes from (in) the interstitium or an increased mixing, i.e., ‘macrostirring’ caused by the exchange procedure per se. We have investigated these possibilities during acute PD in rats, by assessing PS for ⁵¹Cr-EDTA as a function of time [PS(t)]. The discharge effect was studied by saturating the peritoneal interstitium with ⁵¹Cr-EDTA by intravenous tracer infusion prior to each dwell and the results compared to those obtained in rats when tracer infusion and dwells were started simultaneously. The potential effect of initial vasodilatation was studied by adding isoproterenol to the dialysis fluid. Finally, the potential influence of an increased interstitial ‘microstirring’, induced by high glucose concentrations, was investigated by comparison of results for 1.36% Dianeal^® with those for 3.86% Dianeal. In nonvasodilated rats there was a significant drop in PS(t) between 2.5 and 15 min regardless of whether the rats were preloaded with tracer or not. However, there were no significant changes in PS(t) within the isoproterenol-treated group, indicating that vasodilatation plays a crucial role for the high PS initially. Furthermore, there was no difference in overall PS for ⁵¹Cr-EDTA among 1.36 and 3.86% Dianeal dwells. In conclusion, we have found that vasodilatation, but not interstitial discharge (or loading), may explain the inflation of PS occurring during the initial part of PD dwells. In addition, ‘macrostirring’, induced by the exchange procedure per se, may also be important.

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Section: Methodsmentioning

confidence: 99%

Enhanced Peritoneal Diffusion Capacity of <sup>51</sup>Cr-EDTA during the Initial Phase of Peritoneal Dialysis Dwells: Role of Vasodilatation, Dialysate ‘Stirring’, and of Interstitial Factors

Carlsson

Rippe²

1998

Blood Purif

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“…The changes in the functional characteristics of the failing peritoneal membrane are best described as an increased functional area of exchange for small solutes (urea, creatinine, and glucose) between the blood and the dialysate, which is described as effective peritoneal surface area (EPSA) [3]. These patients rely on enhanced angiogenesis and, possibly, vasodilation of the peritoneal vessels [4].…”

mentioning

confidence: 99%

Pyridoxamine improves functional, structural, and biochemical alterations of peritoneal membranes in uremic peritoneal dialysis rats

Kakuta

Tanaka²,

Satoh³

et al. 2005

Kidney International

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“…The sodium balance closely correlates with the net fluid removal during continuous ambulatory peritoneal dialysis (CAPD) and is a function of diffusive transport, convection across the peritoneal membrane, and fluid absorption [4,5]. Convection plays an important role in sodium removal.…”

Section: Introductionmentioning

confidence: 99%

Peritoneal Sodium Mass Removal in Continuous Ambulatory Peritoneal Dialysis and Automated Peritoneal Dialysis: Influence on Blood Pressure Control

et al. 2001

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Background/Aim: Sodium and water retention is common in peritoneal dialysis patients and contributes to cardiovascular disease. As peritoneal sodium removal depends partly on dwell time, and automated peritoneal dialysis (APD) often uses short dwell time exchanges, the aim of this study was to compare the 24-hour peritoneal sodium removal in APD and standard continuous ambulatory peritoneal dialysis (CAPD) patients and to analyze its possible influence on blood pressure control. Methods: A total of 53 sodium balance studies (30 in APD and 23 in CAPD) were performed in 36 stable peritoneal dialysis patients. The 24-hour net removal of sodium was calculated as follows: M = ViCi – VdCd, where Vd is the 24-hour drained volume, Cd is the solute sodium concentration in Vd, Vi is the amount of solution used during a 24-hour period, and Ci is the sodium concentration in Vi. Peritoneal sodium removal was compared between APD and CAPD patients. Residual renal function, serum sodium concentration, daily urinary sodium losses, weekly peritoneal Kt/V and creatinine clearance, 4-hour dialysate/plasma creatinine ratio, proportion of hypertonic solutions, net ultrafiltration, systolic and diastolic blood pressures, and need for antihypertensive therapy were also compared between the groups. Results: Peritoneal sodium removal was higher (p < 0.001) in CAPD than in APD patients. There were no significant differences in residual renal function, serum sodium concentration, urinary sodium losses, peritoneal urea or creatinine clearances, 4-hour dialysate/plasma creatinine ratio, or proportion of hypertonic solutions between groups. The net ultrafiltration was higher in CAPD patients and correlated strongly (r = 0.82; p < 0.001) with peritoneal sodium removal. In APD patients, peritoneal sodium removal increased significantly only in those patients with a second daytime exchange. The systolic blood pressure was higher (p < 0.05) in APD patients, and the proportion of patients with antihypertensive therapy was also higher in APD patients, although no significant relationship between blood pressure values and amount of peritoneal sodium removal was found. Conclusions: The 24-hour sodium removal is higher in CAPD than in APD patients, and there is a trend towards better hypertension control in CAPD patients. As hypertension control and volume status are important indices of peritoneal dialysis adequacy, our results have to be considered in the choice of the peritoneal dialysis modality.

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Peritoneal physiology-transport of solutes

Cited by 80 publications

References 183 publications

Enhanced Peritoneal Diffusion Capacity of <sup>51</sup>Cr-EDTA during the Initial Phase of Peritoneal Dialysis Dwells: Role of Vasodilatation, Dialysate ‘Stirring’, and of Interstitial Factors

Enhanced Peritoneal Diffusion Capacity of <sup>51</sup>Cr-EDTA during the Initial Phase of Peritoneal Dialysis Dwells: Role of Vasodilatation, Dialysate ‘Stirring’, and of Interstitial Factors

Pyridoxamine improves functional, structural, and biochemical alterations of peritoneal membranes in uremic peritoneal dialysis rats

Peritoneal Sodium Mass Removal in Continuous Ambulatory Peritoneal Dialysis and Automated Peritoneal Dialysis: Influence on Blood Pressure Control

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