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Peritoneal Fluid Transport rather than Peritoneal Solute Transport Associates with Dialysis Vintage and Age of Peritoneal Dialysis Patients


Affiliations
1 Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, 02 109 Warsaw, Poland
2 Military Institute of Medicine, 04 141 Warsaw, Poland
3 Divisions of Baxter Novum and Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 52 Stockholm, Sweden
 

During peritoneal dialysis (PD), the peritoneal membrane undergoes ageing processes that affect its function. Here we analyzed associations of patient age and dialysis vintage with parameters of peritoneal transport of fluid and solutes, directly measured and estimated based on the pore model, for individual patients. Thirty-three patients (15 females; age 60 (21–87) years; median time on PD 19 (3–100) months) underwent sequential peritoneal equilibration test. Dialysis vintage and patient age did not correlate. Estimation of parameters of the two-pore model of peritoneal transport was performed.The estimated fluid transport parameters, including hydraulic permeability (LpS), fraction of ultrasmall pores αu), osmotic conductance for glucose (OCG), and peritoneal absorption, were generally independent of solute transport parameters (diffusive mass transport parameters). Fluid transport parameters correlated whereas transport parameters for small solutes and proteins did not correlate with dialysis vintage and patient age. Although LpS and OCG were lower for older patients and those with long dialysis vintage, αu was higher.Thus, fluid transport parameters—rather than solute transport parameters—are linked to dialysis vintage and patient age and should therefore be included when monitoring processes linked to ageing of the peritoneal membrane.
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  • Peritoneal Fluid Transport rather than Peritoneal Solute Transport Associates with Dialysis Vintage and Age of Peritoneal Dialysis Patients

Abstract Views: 113  |  PDF Views: 3

Authors

Jacek Waniewski
Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, 02 109 Warsaw, Poland
Stefan Antosiewicz
Military Institute of Medicine, 04 141 Warsaw, Poland
Daniel Baczynski
Military Institute of Medicine, 04 141 Warsaw, Poland
Jan Poleszczuk
Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, 02 109 Warsaw, Poland
Mauro Pietribiasi
Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, 02 109 Warsaw, Poland
Bengt Lindholm
Divisions of Baxter Novum and Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 52 Stockholm, Sweden
Zofia Wankowicz
Military Institute of Medicine, 04 141 Warsaw, Poland

Abstract


During peritoneal dialysis (PD), the peritoneal membrane undergoes ageing processes that affect its function. Here we analyzed associations of patient age and dialysis vintage with parameters of peritoneal transport of fluid and solutes, directly measured and estimated based on the pore model, for individual patients. Thirty-three patients (15 females; age 60 (21–87) years; median time on PD 19 (3–100) months) underwent sequential peritoneal equilibration test. Dialysis vintage and patient age did not correlate. Estimation of parameters of the two-pore model of peritoneal transport was performed.The estimated fluid transport parameters, including hydraulic permeability (LpS), fraction of ultrasmall pores αu), osmotic conductance for glucose (OCG), and peritoneal absorption, were generally independent of solute transport parameters (diffusive mass transport parameters). Fluid transport parameters correlated whereas transport parameters for small solutes and proteins did not correlate with dialysis vintage and patient age. Although LpS and OCG were lower for older patients and those with long dialysis vintage, αu was higher.Thus, fluid transport parameters—rather than solute transport parameters—are linked to dialysis vintage and patient age and should therefore be included when monitoring processes linked to ageing of the peritoneal membrane.