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Perit Dial Int 28(1): 53-60 2008
© 2008 International Society for Peritoneal Dialysis
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ORIGINAL ARTICLES

HOW ACCURATE IS THE DESCRIPTION OF TRANSPORT KINETICS IN PERITONEAL DIALYSIS ACCORDING TO DIFFERENT VERSIONS OF THE THREE-PORE MODEL?

Jacek Waniewski1,2, Malgorzata Debowska1 and Bengt Lindholm2

Institute of Biocybernetics and Biomedical Engineering,1 Warsaw, Poland; Divisions of Baxter Novum and Renal Medicine,2 Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

Correspondence to: J. Waniewski, Institute of Biocybernetics and Biomedical Engineering, Trojdena 4, PL 02 109 Warzaw, Poland. jacekwan{at}ibib.waw.pl

{diamondsuit} Objective: The three-pore model of peritoneal transport is used extensively for modeling peritoneal fluid and solute transport, but the currently used versions include certain modifications of the transport parameters that have not been validated quantitatively versus detailed data on fluid and solute kinetics. The aim of this study was to evaluate different versions of the three-pore model.

{diamondsuit} Method: Detailed clinical peritoneal fluid and solute transport data were obtained from 40 peritoneal dwell studies in clinically stable continuous ambulatory peritoneal dialysis patients in whom the dialysate volume was measured using a macromolecular volume marker (RISA).

{diamondsuit} Results: Using a new version of the three-pore model with several adjusted transport parameters, good agreement between the measured and the simulated values of dialysate volume and concentrations of small solutes and RISA (but not of endogenous protein) versus dwell time was obtained; however, the predicted peritoneal absorption for longer than the investigated dwell time would be too high.

{diamondsuit} Conclusion: The three-pore model, with some adjustments proposed in this study, may be used for detailed description of peritoneal transport kinetics, but it should be pointed out that, even after these adjustments, it still does not provide the correct description of peritoneal fluid absorption and transport of macromolecules.

KEY WORDS: Mathematical modeling; diffusion; convection; absorption; Starling forces; macromolecules.

Received 4 April 2007; accepted 10 August 2007.






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