Effects of Peritoneal Resting on Peritoneal Fluid Transport Kinetics

2007 ◽  
Vol 27 (5) ◽  
pp. 575-579 ◽  
Author(s):  
Xing-wei Zhe ◽  
Xin-kui Tian ◽  
Lei Cheng ◽  
Tao Wang
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Fluid ◽  
Absorption Rate ◽  
Fluid Transport ◽  
Fluid Absorption ◽  
Peritoneal Membrane ◽  
Dialysis Patients ◽  
Dialysis Solution ◽  
Before And After ◽  
Glucose Exposure

Background Peritoneal resting has been used to restore peritoneal ultrafiltration capacity in peritoneal dialysis patients. Therefore, in the present study, we made a detailed investigation on the effects of peritoneal resting on peritoneal fluid transport characteristics in patients on continuous ambulatory peritoneal dialysis (CAPD). Methods A temporary transfer to daytime ambulatory peritoneal dialysis with a nocturnal “empty belly” was applied to let the peritoneal membrane rest overnight in patients with poor ultrafiltration capacity. All included patients were asked to record appropriately their dialysis exchanges for the assessment of peritoneal fluid transport characteristics, which were evaluated before and after peritoneal resting. Results Seven CAPD patients were included in the present study. There was a significant improvement in peritoneal ultrafiltration capacity as assessed by ultrafiltration volume per gram of glucose load. Patients’ daily glucose exposure and dialysate-to-plasma ratio of creatinine were significantly decreased after peritoneal resting. The peritoneal fluid absorption rate was also significantly decreased after peritoneal resting: 1.011 ± 0.4484 versus 0.625 ± 0.3833 mL/minute. Conclusion The present study suggests that peritoneal resting can improve CAPD patients’ ultrafiltration capacity and decrease the use of hypertonic dialysis solution. The improved ultrafiltration capacity by peritoneal resting was due to decreased membrane solute transport rate and decreased peritoneal fluid absorption rate.

Hyaluronan Preserves Peritoneal Membrane Transport Properties

2001 ◽  
Vol 21 (2) ◽  
pp. 136-143 ◽  
Author(s):  
Qun-Ying Guo ◽  
Wen-Xing Peng ◽  
Hui-Hong Cheng ◽  
Ren-Gao Ye ◽  
Bengt Lindholm ◽  
...  
Keyword(s):  
Membrane Transport ◽  
Peritoneal Fluid ◽  
Absorption Rate ◽  
Control Group ◽  
Fluid Absorption ◽  
Peritoneal Membrane ◽  
Lymphatic Absorption ◽  
Dialysis Solution ◽  
Significant Difference ◽  
And Control

Background We have shown that intraperitoneal (IP) addition of hyaluronan (HA) in a single dwell study in rat could increase peritoneal fluid removal by decreasing the peritoneal fluid absorption rate. In this study, we investigated the impact of repeated use of HA on peritoneal membrane transport characteristics. Methods Twelve male Sprague–Dawley rats received a once-daily IP injection of 25 mL 4.25% glucose dialysis solution without (HP group, n = 6) or with 0.025% HA (HA group, n = 6) for 1 week. Forty-eight hours after the last injection, a 4 hour dwell using 25 mL 4.25% glucose dialysis solution with IP volume marker and frequent dialysate and blood samplings was performed in each rat as well as in rats that did not receive any injection (control group, n = 8). Results Although the IP volumes were significantly lower in the HP and HA groups compared to the control group, IP volume in the HA group was significantly higher than in the HP group. Net ultrafiltration at 4 hours was 5.6 ± 1.3 mL, 10.2 ± 1.8 mL, and 13.2 ± 0.6 mL for the H P, HA, and control group, respectively. The peritoneal fluid absorption rate decreased by 45% in the HA group compared to the HP group. There was no significant difference in peritoneal fluid absorption rate between the HA and the control group. No difference was found in the direct lymphatic absorption rate between the HP and HA groups [0.010 ± 0.003 mL/minute in the HP group and 0.011 ± 0.004 mL/min in the HA group] although they were both higher than that of the control group (0.004 ± 0.001 mL/min). The solute transport rates were in general significantly higher in the HP group compared to the HA and control groups, and there was no significant difference between the latter two groups, except that protein transport rate was significantly lower in the HA group compared to the control group. Conclusions The present study suggests that ( 1 ) repeated exposure to hypertonic glucose-based dialysis solution results in increased peritoneal solute transport rates, as well as increased peritoneal fluid absorption rates; and ( 2 ) these changes, reflecting a highly permeable peritoneal membrane, were ameliorated by repeated IP addition of hyaluronan. The similar changes in the direct lymphatic absorption rate in rats that received daily IP injection of dialysis solution suggest that direct peritoneal lymphatic absorption was not influenced by hyaluronan.

scholarly journals Hyaluronan decreases peritoneal fluid absorption in peritoneal dialysis.

1997 ◽  
Vol 8 (12) ◽  
pp. 1915-1920
Author(s):  
T Wang ◽  
C Chen ◽  
O Heimbürger ◽  
J Waniewski ◽  
J Bergström ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Fluid ◽  
Protein Transport ◽  
Intraperitoneal Administration ◽  
Control Group ◽  
Fluid Absorption ◽  
Sprague Dawley ◽  
Transfer Coefficients ◽  
Fluid Removal ◽  
Dialysis Solution

Hyaluronan, exhibiting a high resistance against water flow, acts in the tissue as a barrier against rapid changes in water content. To test whether hyaluronan has any effect on the peritoneal fluid and solute transport, and, in particular, on the peritoneal fluid absorption, a 4-h dwell study with an intraperitoneal volume marker (radiolabeled human serum albumin [RISA]) was conducted in 21 male Sprague Dawley rats (three groups, seven rats in each group). Each rat was injected intraperitoneally with 25 ml of 1.36% glucose solution alone (control group), with 0.005% hyaluronan (HA1 group), or with 0.01% hyaluronan (HA2 group). Dialysate and blood samples were taken frequently for analyses of fluid and solute (urea, glucose, and protein) transport. The intraperitoneal volume was calculated from the dilution of RISA with a correction for RISA disappearance from the peritoneal cavity. This study shows that adding hyaluronan to peritoneal dialysis solution significantly (P < 0.01) increased the net peritoneal fluid removal, mainly due to a significant decrease in the peritoneal fluid absorption rate (P < 0.01). The diffusive mass transfer coefficients for glucose, urea, and protein did not differ between the three groups. The peritoneal clearance of urea increased significantly in the two hyaluronan groups compared with the control group, due to the increased net fluid removal in the hyaluronan groups. These results suggest that intraperitoneal administration of hyaluronan during a single peritoneal dialysis exchange may significantly increase the peritoneal fluid and solute removal by decreasing peritoneal fluid absorption.

Peritoneal Solute Clearances after four Years of Continuous Ambulatory Peritoneal Dialysis (CAPD)

1989 ◽  
Vol 9 (1) ◽  
pp. 75-78 ◽  
Author(s):  
Min Sun Park ◽  
Jean Lee ◽  
Moon Sung Lee ◽  
Seung Ho Baick ◽  
Seung Duk Hwang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Glucose Absorption ◽  
Peritoneal Membrane ◽  
Vasoactive Agents ◽  
Membrane Function ◽  
Dialysis Solution ◽  
Before And After ◽  
Dialysate Volume

In order to evaluate peritoneal membrane function and responsiveness of peritoneal microcirculation to vasoactive agents in long-term continuous ambulatory peritoneal dialysis (CAPD) patients, we studied peritoneal clearances of urea (Curea) and creatinine (Ccr), protein concentrations in drained dialysate (D PC), peritoneal glucose absorption (% GA), and drained dialysate volume ( VD) before and after nitroprusside (NP) addition to dialysis solution in 17 long-term CAPD patients (mean duration of CAPD: 52 months) and the results were compared to those of 18 patients who were just trained for CAPD (mean duration: 0.6 month). There were no differences in the control (without NP) Curea, Ccr, D PC, %GA, and VD between the new and long-term CAPD patients. Curea, Ccr, and D PC increased significantly with NP in both new and long-term patients. Curea and Ccr with NP were not different between the new and long-term patients but D PC with NP was significantly lower in the long-term CAPD patients. The results of this study suggest that peritoneal solute clearances and the responsiveness of peritoneal microcirculation to NP remain unchanged after four years of CAPD, despite recurrent episodes of peritonitis.

scholarly journals Threefold Peritoneal Test of Osmotic Conductance, Ultrafiltration Efficiency, and Fluid Absorption

2013 ◽  
Vol 33 (4) ◽  
pp. 419-425 ◽  
Author(s):  
Jacek Waniewski ◽  
Ramón Paniagua ◽  
Joanna Stachowska–Pietka ◽  
María-de-Jesús Ventura ◽  
Marcela Ávila–Díaz ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Solute Transport ◽  
Peritoneal Fluid ◽  
Absorption Rate ◽  
Transport Parameter ◽  
Fluid Absorption ◽  
Transport Parameters ◽  
Fluid Removal ◽  
Modifiable Factors ◽  
Small Solute

BackgroundFluid removal during peritoneal dialysis depends on modifiable factors such as tonicity of dialysis fluids and intrinsic characteristics of the peritoneal transport barrier and the osmotic agent—for example, osmotic conductance, ultrafiltration efficiency, and peritoneal fluid absorption. The latter parameters cannot be derived from tests of the small-solute transport rate. We here propose a simple test that may provide information about those parameters.MethodsVolumes and glucose concentrations of drained dialysate obtained with 3 different combinations of glucose-based dialysis fluid (3 exchanges of 1.36% glucose during the day and 1 overnight exchange of either 1.36%, 2.27%, or 3.86% glucose) were measured in 83 continuous ambulatory peritoneal dialysis (CAPD) patients. Linear regression analyses of daily net ultrafiltration in relation to the average dialysate-to-plasma concentration gradient of glucose allowed for an estimation of the osmotic conductance of glucose and the peritoneal fluid absorption rate, and net ultrafiltration in relation to glucose absorption allowed for an estimation of the ultrafiltration effectiveness of glucose.ResultsThe osmotic conductance of glucose was 0.067 ± 0.042 (milliliters per minute divided by millimoles per milliliter), the ultrafiltration effectiveness of glucose was 16.77 ± 7.97 mL/g of absorbed glucose, and the peritoneal fluid absorption rate was 0.94 ± 0.97 mL/min (if estimated concomitantly with osmotic conductance) or 0.93 ± 0.75 mL/min (if estimated concomitantly with ultrafiltration effectiveness). These fluid transport parameters were independent of small-solute transport characteristics, but proportional to total body water estimated by bioimpedance.ConclusionsBy varying the glucose concentration in 1 of 4 daily exchanges, osmotic conductance, ultrafiltration efficiency, and peritoneal fluid absorption could be estimated in CAPD patients, yielding transport parameter values that were similar to those obtained by other, more sophisticated, methods.

Does the Biocompatibility of the Peritoneal Dialysis Solution Matter in Assessment of Peritoneal Function?

2007 ◽  
Vol 27 (6) ◽  
pp. 691-696 ◽  
Author(s):  
Alena Parikova ◽  
Dirk G. Struijk ◽  
Machteld M. Zweers ◽  
Monique Langedijk ◽  
Natalie Schouten ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Fluid Transport ◽  
Low Ph ◽  
Multiple Time ◽  
Peritoneal Membrane ◽  
Transport Parameters ◽  
Solution Ph ◽  
Membrane Function ◽  
Dialysis Solution ◽  
Peritoneal Function

Background Peritoneal function tests are performed in peritoneal dialysis (PD) patients to characterize peritoneal membrane status. A low pH/high glucose degradation product (GDP) dialysis solution is used as the test solution. The objective of the present study was to compare a 3.86% glucose, low pH/high GDP dialysis solution (pH 5.5) with a 3.86% glucose, normal pH/low GDP dialysis solution (pH 7.4) in assessments of peritoneal membrane function. Methods Two standard peritoneal permeability analyses (SPA) were performed in 10 stable PD patients within 2 weeks. One SPA was done with the 3.86% low pH/high GDP solution, and the other with the 3.86% normal pH/low GDP solution. The sequence of the two tests was randomized. Results Fluid transport parameters and glucose absorption were not different between the two groups. No differences were found for the mass transfer area coefficients (MTACs) of low molecular weight solutes calculated over the whole dwell. However, MTAC urea in the first hour of the dwell was higher in the test done with low pH/high GDP dialysate, suggesting more peritoneal vasodilation. No difference was found in protein clearances. Sodium sieving at multiple time points during the dwell was similar with the two solutions. Conclusion The results obtained with the glucose-containing normal pH/low GDP dialysis solution were similar to those obtained with the glucose-containing low pH/high GDP dialysate in assessments of peritoneal membrane function.

Evaluating Peritoneal Fluid Transport in Continuous Peritoneal Dialysis Patients: A Practical Approach

2007 ◽  
Vol 107 (4) ◽  
pp. c123-c127
Author(s):  
Xing-wei Zhe ◽  
Xin-kui Tian ◽  
Yi-sheng Shan ◽  
Lei Cheng ◽  
Tao Wang
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Fluid ◽  
Fluid Transport ◽  
Practical Approach ◽  
Dialysis Patients ◽  
Continuous Peritoneal Dialysis
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