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Perit Dial Int 29(6): 664-669
2009
© 2009 International Society for Peritoneal Dialysis
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ORIGINAL ARTICLES

WATER AND SOLUTE TRANSPORT THROUGH DIFFERENT TYPES OF PORES IN PERITONEAL MEMBRANE IN CAPD PATIENTS WITH ULTRAFILTRATION FAILURE

Jacek Waniewski1,2, Malgorzata Debowska1 and Bengt Lindholm2

Institute of Biocybernetics and Biomedical Engineering,1 Warsaw, Poland; Division of Baxter Novum,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 Warsaw, Poland. jacek.waniewski{at}ibib.waw.pl

Free water transport, an estimate of aquaporin function, was evaluated in 7 continuous ambulatory peritoneal dialysis (CAPD) patients with permanent ultrafiltration failure. In 3 patients, peritoneal transport was studied also before the onset of ultrafiltration failure. Transcapillary ultrafiltration and fluid absorption rates were assessed using radiolabeled albumin, and free water transport by kinetics of sodium concentration in dialysis fluid. Diffusive and convective transport rates of small solutes were estimated using the modified Babb–Randerson–Farrell model. Increased diffusive transport of small solutes was found in 5 patients and increased peritoneal fluid absorption in 2 patients. The 3-pore model was fitted to these data. Overall, hydraulic conductivity and the fractional contributions of aquaporins to hydraulic conductivity were either decreased or normal. We conclude that the quantitative role of aquaporins in overall fluid transport may vary substantially in normal patients as well in patients with ultrafiltration failure.

KEY WORDS: Peritoneal transport; sieving coefficient; mathematical modeling; free water fraction; sodium kinetics; aquaporins.

Received 13 December 2007; accepted 28 November 2008.






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