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Perit Dial Int 16(Suppl_1): 63-69 1996
© 1996 International Society for Peritoneal Dialysis
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Peritoneal Dialysis International, Vol 16, Issue Suppl_1, S63-S69
Copyright © 1996 by International Society for Peritoneal Dialysis


Articles

Paradoxes in peritoneal transport of small solutes

J Waniewski, O Heimburger, A Werynski, and B Lindholm

Department of Clinical Sciences, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.

Analysis of kinetic studies of peritoneal solute transport involves the need for discrimination between three transport components: diffusion, convective transport, and peritoneal absorption. The description of convective transport in standard clinical conditions of continuous ambulatory peritoneal dialysis (CAPD), as well as in isochratic measurements, has met some problems related to the paradoxical and often anomalous values of sieving coefficient, a parameter that characterizes solute drag with the flow of ultrafiltrate. A possible explanation of some of these results is the time dependence of the transport parameters, which is in contrast to their assumed steadiness. These anomalies as well as the time dependence of the transport parameters are confined more to the standard glucose-based dialysis fluid than to some alternative dialysis fluids. Furthermore, the most striking anomalies have been found for small electrolytes as well as for osmotic agents, which are applied in high, unphysiological concentrations. These solutes may be involved in the transport between intracellular and extracellular compartments within the peritoneal membrane, which phenomena are not included in the current modeling.




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A. M. Coester, D. G. Struijk, W. Smit, D. R. de Waart, and R. T. Krediet
The cellular contribution to effluent potassium and its relation to free water transport during peritoneal dialysis
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