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B I Rosengren

Publications and source records attributed to B I Rosengren.

4 recordsLinked to original sources

The peritoneal microcirculation in peritoneal dialysis.

This paper deals with the peritoneal microcirculation and with peritoneal exchange occurring in peritoneal dialysis (PD). The capillary wall is a major barrier to solute and water exchange across the peritoneal membrane. There is a bimodal size-selectivity of solute transport between blood and the peritoneal cavity, through pores of radius approximately 40-50 A as well as through a very low number of large pores of radius approximately 250 A. Furthermore, during glucose-induced osmosis during PD, nearly 40% of the total osmotic water flow occurs through molecular water channels, termed "aquaporin-1." This causes an inequality between 1 - sigma and the sieving coefficient for small solutes, which is a key feature of the "three-pore model" of peritoneal transport. The peritoneal interstitium, coupled in series with the capillary walls, markedly modifies small-solute transport and makes large-solute transport asymmetric. Thus, although severely restricted in the blood-to-peritoneal direction, the absorption of large solutes from the peritoneal cavity occurs at a high clearance rate ( approximately 1 mL/min), largely independent of molecular radius. True absorption of macromolecules to the blood via lymphatics, however, seems to be occurring at a rate of approximately 0.2 mL/min. Several controversial issues regarding transcapillary and transperitoneal exchange mechanisms are discussed in this paper.

Aquaporins↗

Hyaluronan and peritoneal ultrafiltration: a test of the "filter-cake" hypothesis.

Adding hyaluronan (HA) to the dialysis fluid seems to improve the efficiency of peritoneal dialysis (PD). This effect may be explained by the gradual formation of a HA "filter-cake" that decreases the tissue hydraulic conductivity. A filter cake (concentration hyperpolarization layer) can be formed when a large, slowly diffusible molecule, such as HA, is partly sieved by the pores of a membrane during the process of transmembrane ultrafiltration. The filter cake then forms at the "uphill" membrane-fluid interface, thereby increasing the resistance to fluid flow across the membrane. To test the filter-cake hypothesis, we investigated the effects of intraperitoneal (IP) HA on peritoneal small solute and water transport by administering HA either during the dwells or as incubations before PD dwells in rats. In the first set of experiments, HA, 0.01% (n = 7), 0.05% (n = 6), and 0.1% (n = 7) was given in 20 mL dialysis fluid (3.86% Dianeal). Control group was instilled with 20 mL of dialysis fluid. Evans Blue (EB) albumin was given as an intra-arterial (IA) bolus and (51)Cr-EDTA as an intravenous (IV) infusion. Plasma and dialysate were sampled up to 240 minutes to determine total peritoneal clearance (Cl), clearance from dialysate to plasma (Cl-->P) of (125)I-albumin (RISA), clearance from plasma to dialysate (Cl-->D) of EB-albumin, and mass transfer area coefficients (MTAC or permeability-surface area products, PS) of (51)Cr-EDTA and glucose. Peritoneal ultrafiltration (UF) was determined from RISA dilution. In the second set of experiments, rats were first incubated with 4 mL of phosphate-buffered saline (PBS) or PBS containing 0.1% HA for 120 minutes. Rats were then dialyzed with HA-free PD fluid, and sampling of plasma and dialysate was performed for 60 minutes. For HA concentrations exceeding 0.01%, UF volumes increased with increasing doses of HA. Small solute MTACs and initial UF were unaffected when HA was either given during the dwell or as a preincubation. Compared with control, there was a significant decrease in RISA-Cl for 0.05% HA and 0.1% HA. Also, Cl-->P decreased significantly compared with control for 0.1% HA. In conclusion, the present data clearly demonstrate that small solute MTACs and the glucose-induced osmotic water transport occurring early in the dwell are not affected by HA. Only the back-filtration of fluid from peritoneum to plasma was affected.

Animals↗

Transcytosis inhibitor N-ethylmaleimide increases microvascular permeability in rat muscle.

N-ethylmaleimide (NEM) has been claimed to markedly inhibit the transvascular passage of small proteins and albumin by interacting with the docking and fusion of plasmalemmal vesicles with their target membranes. To investigate the role of transcytosis in the transcapillary passage of albumin, we assessed the effects of NEM on (125)I-labeled radioiodinated serum albumin clearance (RISA-Cl) from blood to muscle in isolated and maximally vasodilated perfused rat hindquarters, in which vascular pressures, pre- and postcapillary resistances, and the capillary filtration coefficient (CFC) were continuously monitored. NEM (0.3-0.5 mM) caused a marked increase mainly in precapillary vascular resistance. Thus the arterial-to-venous resistance ratio in NEM-treated animals was 3.12 +/- 0.56 versus 1.66 +/- 0.17 during the control period (P < 0.05). Despite that, there was a doubling of both CFC from 0.0363 +/- 0.0028 to 0.0778 +/- 0.0101 ml x min(-1) x mmHg(-1) x 100 g(-1) (P < 0.01) and RISA-Cl, compared with the control situation, signaling markedly increased microvascular permeability. Our results strongly suggest that NEM, besides producing marked vasoconstriction, also causes damage to the capillary endothelium. Thus, instead of inhibiting transvascular transport, NEM may induce increases in the bulk transport of albumin from blood to tissue.

Animals↗

Effects of peritoneal hyaluronidase treatment on transperitoneal solute and fluid transport in the rat.

The importance of the interstitium and its major ground substance component, hyaluronan (HA), for solute and fluid transport across the peritoneal membrane has been debated during the last few years. We therefore partly removed HA from the peritoneal membrane using enzymatic digestion with hyaluronidase for 2 h, after which the transport properties of the peritoneal membrane were studied in peritoneal dialysis dwells. A dialysis fluid containing 3.86% glucose was used. As a marker of macromolecular transport, the total peritoneal clearance of radiolabelled albumin out of the peritoneal cavity and its clearance to plasma were measured, as well as the albumin clearance from plasma to dialysate. Transport of small solutes between plasma and dialysate was measured by assessing the mass transfer area coefficient of 51Cr-EDTA and glucose. Hyaluronidase preincubation yielded a 78% reduction of HA in the superficial layer of the peritoneal membrane, without alterations in the transport of either small or large solutes compared with the situation in preincubated controls. The only changes observed were between rats incubated with either hyaluronidase or vehicle alone compared to non-incubated controls. In conclusion, despite a large reduction of the HA content of the tissues surrounding the peritoneal cavity, hyaluronidase incubation did not produce any significant changes in solute and fluid transport across the peritoneal membrane. Our data indicate that peritoneal membrane HA in physiological concentrations plays a rather subordinate role in the overall transport of small solutes and water across the capillary-interstitial peritoneal barrier.

Albumins↗