Should sodium removal in peritoneal dialysis be estimated from the ultrafiltration volume? View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-03

AUTHORS

Michel Fischbach, Ariane Zaloszyc, Betti Schaefer, Claus Peter Schmitt

ABSTRACT

In peritoneal dialysis (PD), ultrafiltration (UF) volume is the sum of solute-free- and solute-coupled-water removal, a dynamic process throughout the entire dwell exerted via aquaporin-1 (AQP1) and small pores, respectively. Determination of sodium sieving is used as a parameter for AQP1 function analysis, while coupled water removal is essential for adequate sodium and water balance and thus blood pressure control. The diffusive capacity of glucose via the small pores determines the dynamic crystalloid osmotic gradient. The osmotic conductance, i.e., milliliter of UF per gram of glucose absorbed, quantifies cooperation between small-pores and AQP1 channels. In continuous ambulatory peritoneal dialysis, with dwell times beyond glucose-induced sodium-sieving effects, approximate dialytic sodium removal (DSR) may be estimated from the UF volume (in average 100 mmol Na/L UF), while DSR is lower, with shorter cycle times, in automated PD (APD); therefore, effluent sodium concentrations should be measured. Applying dialysis mechanics, i.e., varying dwell time and dwell volume-as proposed in adapted APD to the PD prescription-may provide unmatched high DSR relative to UF volume, findings which are not sufficiently explained by the three-pore model of PD. Overall DSR should therefore be measured rather than estimated from UF volume. More... »

PAGES

419-424

References to SciGraph publications

  • 2000-11. Spurious estimations of sodium removal during CAPD when [Na]+ is measured by Na electrode methodology in KIDNEY INTERNATIONAL
  • 2003-10. Measurement of hydrostatic intraperitoneal pressure: a useful tool for the improvement of dialysis dose prescription in PEDIATRIC NEPHROLOGY
  • 2003-08. Effect of Kt/V on survival and clinical outcome in CAPD patients in a randomized prospective study in KIDNEY INTERNATIONAL
  • 2001-08. Effect of fluid and sodium removal on mortality in peritoneal dialysis patients in KIDNEY INTERNATIONAL
  • 2005-10. The contribution of free water transport and small pore transport to the total fluid removal in peritoneal dialysis in KIDNEY INTERNATIONAL
  • 2003-04. Effect of icodextrin on volume status, blood pressure and echocardiographic parameters: A randomized study in KIDNEY INTERNATIONAL
  • 2013-11. Hydration measurement by bioimpedance spectroscopy and blood pressure management in children on hemodialysis in PEDIATRIC NEPHROLOGY
  • 2014-08. Optimizing peritoneal dialysis prescription for volume control: the importance of varying dwell time and dwell volume in PEDIATRIC NEPHROLOGY
  • 2009-09. Peritoneal dialysis prescription in children: bedside principles for optimal practice in PEDIATRIC NEPHROLOGY
  • 2006-03. Peritoneal transport assessment by peritoneal equilibration test with 3.86% glucose: A long-term prospective evaluation in KIDNEY INTERNATIONAL
  • 1997-12. A quantitative analysis of sodium transport and removal during peritoneal dialysis in KIDNEY INTERNATIONAL
  • 2016-08. Quantitative Histomorphometry of the Healthy Peritoneum in SCIENTIFIC REPORTS
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00467-016-3378-5

    DOI

    http://dx.doi.org/10.1007/s00467-016-3378-5

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1037062432

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27090529


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