title: Threefold peritoneal test of osmotic conductance, ultrafiltration efficiency, and fluid absorption.
abstract: BACKGROUND
  Fluid removal during peritoneal dialysis depends on modifiable factors such as tonicity of dialysis fluids and intrinsic characteristics of the peritoneal transport barrier and the osmotic agent-for example, osmotic conductance, ultrafiltration efficiency, and peritoneal fluid absorption. The latter parameters cannot be derived from tests of the small-solute transport rate. We here propose a simple test that may provide information about those parameters.
  
  
  METHODS
  Volumes and glucose concentrations of drained dialysate obtained with 3 different combinations of glucose-based dialysis fluid (3 exchanges of 1.36% glucose during the day and 1 overnight exchange of either 1.36%, 2.27%, or 3.86% glucose) were measured in 83 continuous ambulatory peritoneal dialysis (CAPD) patients. Linear regression analyses of daily net ultrafiltration in relation to the average dialysate-to-plasma concentration gradient of glucose allowed for an estimation of the osmotic conductance of glucose and the peritoneal fluid absorption rate, and net ultrafiltration in relation to glucose absorption allowed for an estimation of the ultrafiltration effectiveness of glucose.
  
  
  RESULTS
  The osmotic conductance of glucose was 0.067 ± 0.042 (milliliters per minute divided by millimoles per milliliter), the ultrafiltration effectiveness of glucose was 16.77 ± 7.97 mL/g of absorbed glucose, and the peritoneal fluid absorption rate was 0.94 ± 0.97 mL/min (if estimated concomitantly with osmotic conductance) or 0.93 ± 0.75 mL/min (if estimated concomitantly with ultrafiltration effectiveness). These fluid transport parameters were independent of small-solute transport characteristics, but proportional to total body water estimated by bioimpedance.
  
  
  CONCLUSIONS
  By varying the glucose concentration in 1 of 4 daily exchanges, osmotic conductance, ultrafiltration efficiency, and peritoneal fluid absorption could be estimated in CAPD patients, yielding transport parameter values that were similar to those obtained by other, more sophisticated, methods.
authors: Institute of Biocybernetics and Biomedical Engineering PAS,1 Warsaw, Poland. jwaniewski@ibib.waw.pl
authors: Jacek
authors: J
authors: Waniewski
authors: Ramón
authors: R
authors: Paniagua
authors: Joanna
authors: J
authors: Stachowska-Pietka
authors: María-de-Jesús
authors: MD
authors: Ventura
authors: Marcela
authors: M
authors: Ávila-Díaz
authors: Carmen
authors: C
authors: Prado-Uribe
authors: Carmen
authors: C
authors: Mora
authors: Elvia
authors: E
authors: García-López
authors: Bengt
authors: B
authors: Lindholm
mesh_terms: D000328:Adult; D000368:Aged; D001692:Biological Transport; D015314:Dialysis Solutions / Q000378:metabolism / Q000493:pharmacokinetics*; D017097:Electric Impedance; D005260:Female; D005947:Glucose / Q000378:metabolism / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009995:Osmosis; D009997:Osmotic Pressure / Q000502:physiology*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000378:metabolism; D014462:Ultrafiltration; D014882:Water-Electrolyte Balance / Q000502:physiology
chemical_list: D015314:Dialysis Solutions; D005947:Glucose
keywords: Glucose; osmosis; peritoneal transport; ultrafiltration
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