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Daily exposure to dialysis fluid results in changes in peritoneal transport
T Wang1, A R Qureshi, O Heimbürger
1Department of Clinical Science, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
Objective:
To study the effects of daily infusion of peritoneal dialysis fluids on peritoneal transport characteristics.
Design:
Twenty-four rats were randomly divided into three groups: group A, daily infusions of 20 mL 3.86% glucose dialysis function for 10 days (8 rats); group B, daily infusions of 1.36% glucose dialysis solution for 10 days (8 rats); group C, no daily infusion, the control group (8 rats). Twenty-four hours after the last infusion, a 4-hour dwell study using 25 mL 3.86% glucose dialysis solution with frequency dialysate and blood samples was performed in each rat. Radio-labeled human albumin (RISA) was added to the solution as an intraperitoneal volume marker.
Experimental Animals:
Twenty-four male Sprague-Dawley rats (300 g) were used.
Main Outcome:
Fluid and small solute (glucose, urea, sodium, potassium, phosphate, and urate) transport characteristics were evaluated.
Results:
After 10 days of exposure to dialysis fluid, the fluid absorption rate increased in the 3.86% dialysate group compared to the other groups (p < 0.05). The clearance of RISA to plasma (an estimation of lymphatic absorption), and the absorption of glucose were significantly increased in the two experimental groups compared to the control group but there was no difference between the two experimental groups. The dialysate/plasma ratio for urea, potassium and urate, and the sieving coefficient for phosphate and urate were significantly higher in the 3.86% dialysate group compared to the other two groups, but there was no significant difference between the 1.36% dialysate group and the control group. The clearances of sodium and potassium were significantly lower in the 3.86% dialysate group compared to the control group.
Conclusion:
Our results suggest that (1) daily infusion of dialysis fluid into the peritoneal cavity may increase peritoneal lymphatic absorption: (2) daily infusion of 3.86% glucose dialysate may increase peritoneal transport for small solutes.