Contribution of lymphatic absorption to loss of ultrafiltration and solute clearances in continuous ambulatory peritoneal dialysis.

Mactier, Robert; Khanna, Ramesh; Twardowski, Zbylut J.; Moore, Harold L.; Nolph, Karl D.

doi:10.1172/jci113207

Cited by 151 publications

(66 citation statements)

References 21 publications

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“…52 The net ultrafiltration volume at the end of a PD exchange equals the cumulative net transcapillary water transport minus lymphatic absorption during the exchange. 53 We showed that lymphatic vessels are present in both the peritoneal and pleural sides of the normal rat diaphragm but are rarely detectable in the normal rat parietal peritoneum ( Figure 6). Interestingly, LYVE-1 and VEGFR-3 mRNA levels were higher in the diaphragm than the parietal peritoneal wall.…”

Section: Discussionmentioning

confidence: 83%

TGF-β1 Promotes Lymphangiogenesis during Peritoneal Fibrosis

Kinashi¹,

Ito²,

Mizuno³

et al. 2013

Journal of the American Society of Nephrology

129

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Section: Discussionmentioning

confidence: 83%

TGF-β1 Promotes Lymphangiogenesis during Peritoneal Fibrosis

Kinashi¹,

Ito²,

Mizuno³

et al. 2013

Journal of the American Society of Nephrology

129

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“…Residual, intraperitoneal and net UF volumes were calculated sequentially by standard methods [1,7,8,9,10]. Formulas are listed in table 1.…”

Section: Methodsmentioning

confidence: 99%

Comparisons of the Peritoneal Equilibration Test and Ultrafiltration in Patients with and without Diabetes Mellitus on Continuous Ambulatory Peritoneal Dialysis

et al. 2006

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Background/Aims: To compare dialysance and ultrafiltration (UF) of peritoneum in diabetes mellitus (DM) and non-DM patients on continuous ambulatory peritoneal dialysis. Methods: A total of 162 adult patients on continuous ambulatory peritoneal dialysis (40 DM and 122 non-DM patients) were studied with the peritoneal equilibration test (PET) using 2.5% glucose dialysis solution retained for 4 h. Patients using 2,000 or 1,500 ml of infusion volume were classified into groups A (23 DM and 63 non-DM patients) and B (16 DM and 41 non-DM patients), respectively. PET results were compared between DM and non-DM patients by unpaired t test. Using Pearson’s correlation and least-square multiple regression, the most powerful predictors of UF rate were also evaluated in DM and non-DM patients. Results: There were no differences between PET parameters and UF rate between DM and non-DM patients in the whole group (WG) and group A. The only significant difference (p < 0.05) was an increased D4/D0 value in DM patients in group B. The most simple but powerful method to predict UF rate was (100 – GAP)/(D4/D0), where GAP corresponds to the glucose absorption percentage and D4/D0 is the PET 4-hour dialysate glucose level/PET 0-hour dialysate glucose level. GAP and D4/D0 were two major determinants of UF rate in the DM group, non-DM group and WG. Conclusions: Peritoneal permeability did not differ between DM and non-DM patients, and GAP and D4/D0 were two major factors predicting UF rate.

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“…There is a general consensus that the overall magnitude of this fluid loss averages 1.0-1.5 ml/min [1,2] ( 1.4-2.1 liters/day), with a re ported range (mean ± 2 SD) of 0.3-2.7 ml/ min [3]. This mean value for the patient in overall fluid balance is approximately equal to the daily net ultrafiltration.…”

Section: Introductionmentioning

confidence: 99%

Pathways for Fluid Loss from the Peritoneal Cavity

Shockley

Ofsthun²

1992

Blood Purif

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During peritoneal dialysis, fluid is transported out of the peritoneal cavity by lymphatic and nonlymphatic pathways, thereby decreasing net ultrafiltration by 40-50% and reducing small solute clearance by 15-20%. The direct lymphatic pathway consists of the diaphragmatic lymphatics, which directly connect the peritoneal cavity to the bloodstream. The interstitial lymphatic and direct blood entry pathways convey fluid that has been driven into the interstitial space of the tissue surrounding the peritoneal cavity by the increased intraperitoneal pressure, and return it to the bloodstream. Since flow through lymphatic pathways is only a portion of the flow through all pathways, total fluid loss is greater than lymph flow. The best technique for estimating lymph flow is direct measurement by cannulation of lymphatic vessels, a technique that is not clinically feasible. The tracer disappearance technique, which measures the rate at which macromolecules leave the peritoneal cavity, is an indirect measure of fluid loss. The tracer appearance technique, which measures the rate at which macromolecules reach the blood from the peritoneal cavity, slightly overestimates lymph flow because some tracer may enter the bloodstream directly from the tissues. Much of the previous controversy over the contribution of the lymphatic pathways to total fluid loss can be resolved by understanding the differences in what these techniques measure.

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Contribution of lymphatic absorption to loss of ultrafiltration and solute clearances in continuous ambulatory peritoneal dialysis.

Cited by 151 publications

References 21 publications

TGF-β1 Promotes Lymphangiogenesis during Peritoneal Fibrosis

TGF-β1 Promotes Lymphangiogenesis during Peritoneal Fibrosis

Comparisons of the Peritoneal Equilibration Test and Ultrafiltration in Patients with and without Diabetes Mellitus on Continuous Ambulatory Peritoneal Dialysis

Pathways for Fluid Loss from the Peritoneal Cavity

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