Role of the Peritoneal Microcirculation in Peritoneal Dialysis

Korthuis, Ronald J.; Granger, D. Neil

doi:10.1007/978-94-009-1085-0_3

Cited by 9 publications

(8 citation statements)

References 116 publications

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“…In the present study, we have observed a protein loss of 2-11 g/8 h. This heteroge neity in the peritoneal transport of proteins has been as cribed to constitutional differences in the anatomy and function of the peritoneal membrane among patients such as: microvascular structure [20]; electric charge of the peri toneal membrane [21]; peritoneal mesothelium [22,23]; peritoneal stromal texture [24]; surface area of parietal and visceral peritoneum [23,[25][26][27] and lymphatic absorption [28]. In addition, acquired factors during CAPD have been reported to affect peritoneal permeability to proteins, glu cose absorption rate and ultrafiltration capacity: duration of CAPD [2, 5-7, 29, 30], peritonitis episodes [31][32][33], dialysate composition [30,34] and drug treatment [21,35,36].…”

Section: Discussionmentioning

confidence: 99%

“…As may have been expected, an inverse correlation was observed between peritoneal glucose absorption (both mass transfer and clearance) and serum potassium levels (r = -0.347, p < 0.01 and r = -0.349, p < 0.01, n=49, respectively). 36 Kagan/Bar-Khayim/Schafer/Fainaru Heterogeneity in Peritoneal Transport …”

Section: Effect O F Peritoneal Transport On Plasma Levels O F Solutesmentioning

confidence: 99%

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Heterogeneity in Peritoneal Transport during Continuous Ambulatory Peritoneal Dialysis and Its Impact on Ultraf iltration, Loss of Macromolecules and Plasma Level of Proteins, Lipids and Lipoproteins

Kagan

Bar-Khayim²,

Schafer³

et al. 1993

Nephron

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We investigated the effect of heterogeneity in the peritoneal transport of plasma proteins on dialysis efficiency and plasma levels of proteins, lipids and lipoproteins in 32 patients undergoing long-term continuous ambulatory peritoneal dialysis (CAPD; 9 females and 23 males, 18-76 years old). Eleven patients were studied on several occasions (at 0-42 months) and the remainder at 6-60 months on CAPD (n = 49). We have divided our patients arbitrarily into two equal groups according to their protein concentration in the peritoneal effluent at the end of an 8-hour cycle. Patients with a high peritoneal protein concentration ( ≥ 2 g/l/1.73 m²) have lower ultrafiltration capacity, higher glucose absorption rate and increased loss of most plasma proteins [including albumin, immunoglobulins (Ig), complement components and high-density lipoproteins (HDL)] compared to patients with a low peritoneal protein concentration ( < 2 g/l/ 1.73 m²). Consequently, plasma levels of albumin, IgM and HDL were lower in patients with a high peritoneal protein concentration. The latter had also increased levels of plasma triglycerides and very-low-density lipoproteins. The difference observed in peritoneal transport between the groups could be ascribed only in part to the duration of CAPD treatment, and hence to the number of peritonitis episodes but not to medications. Therefore, we suggest that inherent constitutional factors may be responsible for some of the observed heterogeneity in the peritoneal transport of these patients which is already evident at the start of CAPD treatment. Patients with high peritoneal transport are exposed to an augmented atherogenic plasma lipid profile in addition to a reduction in dialysis efficiency (ultrafiltration failure). These patients may become prone also to nutritional and immunological disturbances. Therefore, we suggest taking these effects into consideration before choosing the appropriate dialysis modality in patients with increased peritoneal transport for plasma proteins.

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Section: Discussionmentioning

confidence: 99%

Section: Effect O F Peritoneal Transport On Plasma Levels O F Solutesmentioning

confidence: 99%

Heterogeneity in Peritoneal Transport during Continuous Ambulatory Peritoneal Dialysis and Its Impact on Ultraf iltration, Loss of Macromolecules and Plasma Level of Proteins, Lipids and Lipoproteins

Kagan

Bar-Khayim²,

Schafer³

et al. 1993

Nephron

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“…The peritoneal surface area of an adult is roughly equal to the skin surface area and averages between 1 and 2 square meters (1 1, 12). While the visceral peritoneum constitutes about 90% of this surface area (13), the parietal peritoneum has a greater vasculature (14). The effective peritoneal membrane available for solute exchange is much less than the total surface area (1 5).…”

Section: Normal Anatomy and Physiology Of The Peritoneummentioning

confidence: 99%

“…The peritoneal membrane vasculature and lymphatic system constitute an efficient and complex solute delivery and removal system ( 17). The visceral and parietal peritoneal arterial supply is derived from two different sources (18). The complexity is then compounded by two different venous systems ( 18).…”

Section: Normal Anatomy and Physiology Of The Peritoneummentioning

confidence: 99%

“…The visceral and parietal peritoneal arterial supply is derived from two different sources (18). The complexity is then compounded by two different venous systems ( 18). Visceral peritoneal veins drain into the portal system and then to the liver; parietal peritoneal veins drain directly into the systemic circulation.…”

Section: Normal Anatomy and Physiology Of The Peritoneummentioning

confidence: 99%

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Ascites in Chronic Hemodialysis: A Review

Tannenberg

1990

Seminars in Dialysis

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Caecum location in laboratory rats and mice: an anatomical and radiological study

Uysal

Gül

Karaman³

et al. 2016

Lab Anim

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Intraperitoneal (i.p.) injection is the most frequently used method for implementing parenteral therapies in rats and mice. Whether the caecum is located in the right caudal quadrant or left caudal quadrant in the abdominal cavity is not clear. For that reason, we have developed a method for identifying the location of the caecum in rats and mice and thus revealed the most reliable location for i.p. injection in these animals. Two hundred Wistar albino rats and 100 BALB/c mice were used. The location of the caecum was determined by revealing the intra-abdominal organs immediately following euthanasia, photographing the organs, and archiving the images. Both digital photographic images and computed tomographic (CT) sections were analysed in terms of caecum morphology and location. In both rats and mice, the caecum was most commonly located on the animal's left side. It was less frequently located on the right side or in the centre. The caecum was typically comma-shaped, but it was round or S-shaped in some animals. The direction of rotation of the caecum from the basis to the apex was mostly counterclockwise. Additionally, the apex showed a tendency to be evenly centred. This study demonstrated that the caecum was mostly located on the animal's left side; and for that reason, the most suitable location for i.p. injection in these animals was understood to be the right caudal quadrant. Furthermore, when we compared the CT images and autopsy findings, the caecum did not change location in the abdominal cavity postmortem.

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Role of the Peritoneal Microcirculation in Peritoneal Dialysis

Cited by 9 publications

References 116 publications

Heterogeneity in Peritoneal Transport during Continuous Ambulatory Peritoneal Dialysis and Its Impact on Ultraf iltration, Loss of Macromolecules and Plasma Level of Proteins, Lipids and Lipoproteins

Heterogeneity in Peritoneal Transport during Continuous Ambulatory Peritoneal Dialysis and Its Impact on Ultraf iltration, Loss of Macromolecules and Plasma Level of Proteins, Lipids and Lipoproteins

Ascites in Chronic Hemodialysis: A Review

Caecum location in laboratory rats and mice: an anatomical and radiological study

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