[The effects of intra-abdominal pressure on regional renal blood flow during peritoneal dialysis]

This experimental studies were designed to investigate the effects of intra-abdominal pressure (IAP) on renal regional blood flow and renal function during peritoneal dialysis (PD) for acute renal failure (ARF). The mongrel dogs were divided into four groups. Group I (n = 10): IAP of atmospheric pressure without PD (control group); Group II (n = 10): Intermittent PD with IAP of 10 mmHg; Group III (n = 10): Intermittent PD with IAP of 20 mmHg; Group IV (n = 10): Continuous PD with IAP of 3-5 mmHg. The following results were obtained. Significant decrease (p less than 0.01-0.05) of renal cortical blood flow (RCBF), total renal blood flow (TRBF), ratio of RCBF to renal medullar blood flow, renal perfusion pressure (RPP), cardiac index and urinary output, and increased renal vascular resistance and inferior vena caval pressure were observed in group III, but in group IV, values of these parameters returned to control level. The limit of influence to renal function was confirmed to be as follows. (1) IAP of 30 mmHg or more, (2) RPP of less than 65 mmHg, (3) TRBF of less than 2.2 ml/g/min, (4) and RCBF of less than 78 ml/100 g/min. These studies suggest that RPP are simple and excellent index to reflex renal hemodynamics, and the continuous PD are better procedure than the intermittent PD from a view of renal regional blood flow.