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B Rippe

Publications and source records attributed to B Rippe.

At least 19 recordsLinked to original sources
PubMed1996

Liver is not essential for solute transport during peritoneal dialysis.

Based on theoretical calculations on solute exchange capacities of various peritoneal tissues, the liver has been predicted to account for up to 43% of the permeability-surface area product (PS) of the entire peritoneal "membrane" for a small solute (sucrose) during peritoneal dialysis (PD). In these calculations, the abdominal wall and the diaphragm were found to contribute only approximately 10 to 15% of the total PS. However, evisceration has in previous studies been shown to affect the PS characteristics during PD only marginally (10 to 30%). In such evisceration experiments the liver was usually not removed, and therefore it has been suggested that an intact liver might have significantly contributed to the solute exchange under these premises. We assessed the peritoneal PS of 51Cr-EDTA (constantly infused intravenously) and the plasma-to-peritoneal clearance (ClB-->P) of 125I-human serum albumin (RISA) (given as an i.v. bolus) in Wistar rats during acute PD. In one group of rats the liver surface was sealed off using Histoacrylate glue (N = 6) and in another group a 90% hepatectomy was performed, the remaining portion of the liver, usually the right lower lobe, being sealed off by glue (N = 6). A third group was sham operated to serve as control (N = 12). The PS for 51Cr-EDTA was 0.32 +/- 0.03(+/- SE) ml. min-1 (N = 12) during control, 0.32 +/- 0.04 ml.min-1 after "sealing" of the liver surface (N = 6, P > 0.1) and 0.40 +/- 0.03 after hepatectomy (N = 6, P > 0.1), that is, remained unchanged after experimental intervention. The CIB-->P of RISA during control was 5.88 +/- 1.0 microliter.min-1 (N = 10), and was not altered after hepatectomy, 6.17 +/- 0.48 microliters.min-1 (N = 5, P > 0.1), but slightly increased after liver surface sealing (9.69 +/- 1.09 microliters.min-1, N = 5, P < 0.05). In conclusion, the present experiments indicate that the liver does not play an essential role in the overall solute exchange between the plasma and the peritoneal cavity (PC) during PD.

Animals↗
PubMed1996

Transport of tracer albumin from peritoneum to plasma: role of diaphragmatic, visceral, and parietal lymphatics.

Using a technique to acutely seal off various parts of the peritoneal membrane surface, with or without evisceration, we investigated the role of diaphragmatic, visceral, and parietal peritoneal lymphatic pathways in the drainage of 125I-labeled albumin (RISA) from the peritoneal cavity to the plasma during acute peritoneal dialysis in artificially ventilated rats. The total RISA clearance out of the peritoneal cavity (Cl) as well as the portion of this Cl reaching the plasma per unit time (Cl--> P) were assessed. Under non-steady-state conditions, the Cl was fivefold higher than the Cl--> P. Evisceration caused a 25-30% reduction in both Cl--> P and Cl. Sealing of the diaphragm, however, reduced the Cl--> P by 55% without affecting the Cl. A further reduction in the Cl--> P was obtained by combining sealing of the diaphragm with evisceration, which again markedly reduced the Cl. However, the greatest reduction in the Cl was obtained when the peritoneal surfaces of the anterior abdominal wall were sealed off in eviscerated rats. The discrepancy between the Cl and the Cl--> P can be explained by the local entrance of fluid and macromolecules into periabdominal tissues, where fluid is rapidly absorbed through the capillary walls via the Starling forces, while macromolecules are accumulating due to their very slow uptake by tissue lymphatics under non-steady-state conditions. Of the portion of the total Cl that rapidly entered the plasma, conceivably by lymphatic absorption, 55% could be ascribed to diaphragmatic lymphatics 30% to visceral lymphatics, and only some 10-15% to parietal lymphatics.

Animals↗
PubMed1996

In vivo inhibition of transcellular water channels (aquaporin-1) during acute peritoneal dialysis in rats.

During peritoneal dialysis (PD), a major portion of the osmotically induced water transport to the peritoneum can be predicted to occur through endothelial water-selective channels. Aquaporin-1 (AQP-1) has recently been recognized as the molecular correlate to such channels. Aquaporins can be inhibited by mercurials. In the present study, HgCl2 was applied locally to the peritoneal cavity in rats after short-term tissue fixation, used to protect the tissues from HgCl2 damage. Dianeal (3.86%) was employed as dialysis fluid, 125I-albumin as an intraperitoneal volume marker, and 51Cr-EDTA (constantly infused intravenously) to assess peritoneal small-solute permeability characteristics. Immunocytochemistry and immunoelectron microscopy revealed abundant AQP-1 labeling in capillary endothelium in peritoneal tissues, representing sites for HgCl2 inhibition of water transport. HgCl2 treatment reduced water flow and inhibited the sieving of Na+ without causing any untoward changes in microvascular permeability, compared with that of fixed control rats, in which the peritoneal cavity was exposed to tissue fixation alone. In fixed control rats, the mean intraperitoneal volume (IPV) increased from 20.5 +/- 0.15 to 25.0 +/- 0.52 ml in 60 min, whereas in the HgCl2-treated rats, the increment was only from 20.7 +/- 0.23 to 23.5 +/- 0.4 ml. In fixed control rats, the dialysate Na+ fell from 135.3 +/- 0.97 to 131.3 +/- 1.72 mM, whereas in the HgCl2-treated rats the dialysate Na+ concentration remained unchanged between 0 and 40 min, further supporting that water channels had been blocked. Computer simulations of peritoneal transport were compatible with a 66% inhibition of water flow through aquaporins. The observed HgCl2 inhibition of transcellular water channels strongly indicates a critical role of aquaporins in PD and provides evidence that water channels are crucial in transendothelial water transport when driven by crystalloid osmosis.

Animals↗
PubMed1996

Theoretical analysis of osmotic agents in peritoneal dialysis. What size is an ideal osmotic agent?

In this article the difference between osmotic fluid flow (ultrafiltration) as driven by osmotic pressure and diffusion through thin leaky membranes is discussed. It is pointed out that water transport induced by osmosis is fundamentally different from the process of water diffusion. Applying modern hydrodynamic pore theory, the molar solute concentration and the solute concentration in grams per 100 mL, exerting the same initial transmembrane osmotic pressure as a 1% glucose solution, was investigated as a function of solute molecular weight (MW). It was then assumed, base on experimental data, that the major pathway responsible for the peritoneal osmotic barrier characteristics is represented by pores of radius approximately 47 A. With increasing solute radius, the osmotic reflection coefficient (sigma) and, hence, the osmotic efficiency per mole of solute will increase. However, simultaneously, the molar concentration per unit solute weight will decrease. The balance point between these two events apparently occurs at a solute MW of approximately 1 kDa. An additional advantage of using solutes of high MW as osmotic agents during peritoneal dialysis (PD), rather than increased osmotic efficiency per se, lies in the fact that large solutes, due to their low peritoneal diffusion capacity, will maintain a sustained rate of ultrafiltration (osmosis) over a prolonged period. To illustrate this, we have performed computer simulations of peritoneal fluid transport according to the three-pore model of peritoneal permselectivity. According to these simulations, 4% of an 800 Da polymer solution (+50 mmol/L above isotonicity) will produce the same cumulative amount of intraperitoneal fluid volume ultrafiltered (UF) during 360-400 minutes as 4% of a 2 kDa polymer solution (+20 mmol/L) or 6.5% of a 10 kDa polymer solution (+6.5 mmol/L) having the same electrolyte concentration as dialysis solutions conventionally used for PD. Similar cumulative UF volumes (during 400 minutes) can be obtained by a 2.5% glycerol (+272 mmol/L) or a 3.2% glucose-containing dialysis solution (+177 mmol/L) with conventional electrolyte composition.

Dialysis Solutions↗
PubMed1996

Less infusion pain and elevated level of cancer antigen 125 by the use of a new and more biocompatible PD fluid.

Our objective was to investigate the clinical effect of a less toxic and less acidic peritoneal dialysis (PD) fluid produced in a two-compartment bag (PD-Bio). The study had an open cross-over design in 4 stable patients, where the patient served as his/her own control. After a period of three months using conventional PD fluid the patients were switched to three months on the new PD fluid. Routine blood chemistry and transport characteristics were measured. Cell samples from overnight spent dialysis fluid were analyzed for viability, differential count, release of superoxide radicals, and cancer antigen 125 (CA 125). Subjective patient symptoms and handling properties were investigated by a patient questionnaire. Cancer antigen 125 increased significantly, and patients with discomfort or infusion pain during the control period improved during the PD-Bio period. Patient acceptance with respect to handling of the two-compartment bag was excellent and did not differ from the use of standard bags. No changes were seen in the cell samples from spent dialysate, blood chemistry, or transport characteristics between the two treatment periods. PH in the effluent dialysate was, however, significantly higher for PD-Bio at all times during the two-hour dwell. Our results suggest that a PD fluid produced to minimize the level of toxic glucose degradation products and to obtain a more physiological pH has an impact on CA 125 levels, reduces pain and discomfort in connection with infusion of fluid, and does not influence the transport characteristics.

CA-125 Antigen↗
PubMed1995

Intraperitoneal fluid volume changes during peritoneal dialysis in the rat: indicator dilution vs. volumetric measurements.

In order to validate the single injection RISA (125I human serum albumin) indicator diluation technique for assessing the alterations in intraperitoneal (i.p.) dialysate volume (IPV) which occur vs. time [V(t)] during peritoneal dialysis (PD), the RISA dilution technique was compared to V(t) determinations using a direct volume recovery method in Wistar rats. Sixteen milliliters of either 1.36 or 3.86% Dianeal or 0.9% NaCl were used as dialysis fluids in exchanges lasting between 1 and 360 min. Approximately 4% (4.41 +/- 0.59 (SE; n = 8) for 1.36% Dianeal and 4.07 +/- 0.72 (n = 4) for 3.86% Dianeal) of the RISA dose given intraperitoneally was lost from the dialysate during the first 1(-1.5) min after instillation, conceivably due to rapid tracer adsorption to peritoneal surfaces. Following the initial instant tracer loss and RISA dilution due to a residual volume (3.07 +/- 0.18 ml; n = 12), RISA disappeared at a fractional rate (FDR) of 2.10 +/- 0.14 x 10(-3) min-1 and 1.67 +/- 0.09 x 10(-3) min-1, during the first 30 min for 1.36 and 3.86% Dianeal, respectively. The overall FDR was 1.33 +/- 0.10 x 10(-3) and 0.707 +/- 0.082 x 10(-3) min-1 for 1.36% Dianeal (0-150 min) and 3.86% Dianeal (0-360 min), respectively, while the overall (0-150 min) FDR for the NaCl exchanges was 1.40 +/- 0.21 x 10(-3) min-1. These values correspond to RISA clearances out of the peritoneal cavity (KE) of 29.2 +/- 1.8, 22.1 +/- 1.6, and 25.7 +/- 2.4 microliter x min-1 for 1.36 and 3.86% Dianeal and 0.9% NaCl, respectively. The KE value for 3.86% Dianeal was significantly (p < 0.05) lower than for the two dialysates with lower osmolality. The slightly enhanced FDR of RISA during the first 30 min was partly due to the presence of nonprotein-bound free iodine in the RISA preparation used, and also to an enhanced disappearance of albumin during the first portion of the dwell. V(t) data from individual experiments using the RISA dilution technique (RISA curves) were analyzed by computer-aided nonlinear least-squares regression analysis.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1995

Elevated plasma levels of acute phase proteins in mesangioproliferative glomerulonephritis, membranous nephropathy and IgA nephropathy.

In order to study the possible role of active inflammatory processes in clinical indolent primary chronic glomerulonephritides, plasma concentrations of the acute phase proteins: alpha 1-antitrypsin, haptoglobin, orosomucoid and C-reactive protein were measured in 166 glomerulonephritis patients. The patients had a diagnosis of either mesangioproliferative glomerulonephritis, membranous nephropathy or immunoglobulin A nephropathy and were divided in two groups, one with heavy urinary albumin losses and one with moderate to slight urinary albumin excretion. The median plasma concentration values for alpha 1-antitrypsin, haptoglobin and orosomucoid were increased in all three kinds of the investigated glomerulonephritides with exception for orosomucoid in patients with heavy urinary albumin losses and in the membranous nephropathy group. The plasma concentration values for C-reactive protein were not elevated at all in the material. The increase of plasma levels of acute phase proteins could be the result of persistent inflammatory stimuli that occur in primary chronic glomerulonephritides. The finding of unchanging plasma levels of C-reactive protein in contrast to increased concentrations of the other acute phase proteins could be of significance in diagnosing infections or other inflammatory diseases in patients with chronic glomerulonephritis.

Acute-Phase Proteins↗
PubMed1995

Peritoneal fluid and tracer albumin kinetics in the rat. Effects of increases in intraperitoneal hydrostatic pressure.

OBJECTIVES: To study the peritoneal fluid loss rate, the clearance (CI) of radioactive tracer albumin (RISA) eliminated from the peritoneal cavity (PC), as well as the peritoneal-to-plasma RISA clearance (CI-->P) during acute peritoneal dialysis (PD) at large elevations in intraperitoneal hydrostatic pressure (IPP). DESIGN: Experimental study in anesthetized Wistar rats. METHODS: The intraperitoneal volume (IPV) was assessed using RISA dilution, correcting for the RISA CI from the PC. Volume recovery at termination of the dwells was obtained using graduated cylinders and preweighed gauze tissues. Measurements of CI and CI-->P were obtained by repeated micro-sampling of dialysate and plasma, respectively. The IPP was continuously measured, and could be varied by external concentric abdominal compression using an inflatable cuff. On termination of the experiments, samples from tissues lining the PC were analyzed with respect to their content of RISA and edema, the latter being assessed from wet/dry weight ratios. RESULTS: At 2 mm Hg of IPP (control) the RISA CI was 27.1 +/- 2.0 (+/- SE) microL.min-1, whereas CI-->P was only 8.07 +/- 0.67 microL.min-1, at a total fluid loss rate of 10.1 +/- 5.4 microL.min-1 for 1.36% Dianeal. At an IPP of 14 mm Hg, the CI increased to 55.3 +/- 4.1 microL.min-1 and the peritoneal fluid absorption rate was 34.4 +/- 5.6 microL.min-1, whereas CI-->P was just moderately increased as compared to control (11.2 +/- 1.4 microL.min-1). Furthermore, a pleural effusion of 1.16 +/- 0.08 mL was detectable at elevated IPPs. The degree of edema formation in the anterior abdominal muscles (AAM) and the diaphragm (DIA) was largely insignificant during 150 min at 2 mm Hg of IPP, but increased markedly at 14 mm Hg, as did the RISA uptake to the AAM and DIA. The discrepancy between CI and CI-->P was largely accounted for by tracer entrance into tissues lining the peritoneal cavity, mainly the AAM. CONCLUSIONS: At a nearly unchanging capillary Starling equilibrium, the losses of fluid and of RISA from the PC were markedly elevated at increased IPPs. However, the RISA clearance to the plasma appeared to be only moderately altered at elevated IPP and represented only a minor fraction of the RISA clearance out of the PC. Tissues lining the PC apparently act as a variable 'sink' for intraperitoneal proteins and fluid during peritoneal dialysis (PD).

Animals↗
PubMed1995

In vitro biocompatibility of a heat-sterilized, low-toxic, and less acidic fluid for peritoneal dialysis.

OBJECTIVE: The aim of this study was to investigate a peritoneal dialysis (PD) fluid (PD-Bio), produced with the intention of reducing the amount of glucose degradation products and to increase the final pH. The heat sterilization of the fluid was performed with the glucose separated from the electrolytes. After sterilization the two solutions were combined. METHODS: The in vitro biocompatibility of PD-Bio was measured as the inhibition of cell growth of a cultured fibroblast cell line and as the stimulated release of interleukin-1 beta from cultured human mononuclear cells. The glucose degradation products were measured as UV absorbance at 228 nm or 284 nm and the concentration of aldehydes was estimated with high-performance liquid chromatography and gas chromatography. RESULTS: Our results demonstrate that in comparison to conventional PD fluids the pH of PD-Bio was increased, to about 6.5. Due to less contaminating glucose degradation products in PD-Bio, basal cytotoxicity was significantly decreased for both 1.5% and 4% glucose-containing fluids, and the stimulated release of interleukin-1 beta was normalized compared to sterile filtered controls with the same pH. UV absorbance measured at 228 nm was decreased, whereas the absorbance at 284 nm was equal to that of a conventional fluid. In PD-Bio the concentrations of formaldehyde, acetaldehyde, methylglyoxal, and 2-furaldehyde were found to be below the detection limit, whereas glyoxal was present in the same and 5-hydroxymethylfurfural (5-HMF) in higher concentrations than in conventionally produced PD fluid. CONCLUSIONS: The results demonstrate that it is possible to improve biocompatibility of PD fluids by simply changing the way the fluid is produced.

Acetaldehyde↗
PubMed1994

Analysis of the pressure-flow characteristics of isolated perfused rat kidneys with inhibited tubular reabsorption.

The renal hemodynamics were studied in an isolated perfused rat kidney model modified for investigations of the glomerular permeability characteristics. The tubular reabsorptive activity was inhibited by perfusion at low temperature (8 degrees C) in the presence of furosemide and nitroprusside resulting in a dramatic increase in the filtered load of fluid and solute reaching the tubules and hence in tubular pressure. The glomerular filtration rate (GFR), arterial pressure (PA) and needle pressure (intrarenal tissue pressure, PiR) were continuously recorded and the glomerular hydrostatic pressure was estimated by an arterial occlusion technique. The pre- to postglomerular resistance ratio was calculated from the pressure vs. GFR relationships for two perfusates having differing oncotic pressures (pi = 5.5 and pi = 20 mmHg), from which estimations of glomerular hydrostatic pressures (PGC) were concomitantly made. Thus, increases in delta pi could be exactly counterbalanced by equally large increases in PGC for any given GFR, the needle and Bowman's capsule pressures being dependent on GFR but not on plasma colloid oncotic pressure. The experimental interventions resulted in a pronounced elevation of PiR as compared with in vivo conditions, while the PGC values were in a normal range, resulting in reduced glomerular filtration pressures. Furthermore, the clearance of albumin varied with the oncotic pressure in agreement with the notion of heteroporosity.

Absorption↗
PubMed1994

Reduced permselectivity in isolated perfused rat kidneys following small elevations of glomerular capillary pressure.

A modified rat kidney preparation was used to explore how changes in hydrostatic pressure affect the permselective properties of the glomerular capillary bed. The maximally vasodilated kidneys of 18 rats were perfused with albumin solutions (16.7 g l-1) at different flow rates and hence arterial pressures (PA). One kidney in each rat was exposed to pressure elevations with the other kidney serving as a control perfused at constant PA of about 100 mmHg. Both the vascular resistance to flow and the glomerular filtration rate (GFR 34.6 +/- 2.9 ml min-1 100 g-1) were similar in the two kidneys at equal PA and remained constant throughout the experiment. The ratio of albumin clearance over GFR (theta) was initially around 0.4% at constant PA and gradually increased during 1.5 h to reach 0.7% at the end of the experiment. A direct increase of PA from 100 to 200 mmHg for 15 min resulted in a calculated increase of the effective glomerular filtration pressure gradient of 10-15 mmHg and in a two-fold increase of theta when measured at an identical PA of 100 mmHg. Albumin clearance was almost fully normalized within 20 min similar to that observed in e.g. skeletal muscle. However, the glomerular capillary barrier seemed to be far more sensitive to elevations of hydrostatic pressure than other capillary walls which require capillary pressure increments of 60 mmHg in order to induce similar reversible changes in permeability. Therefore, we conclude that an elevated PGC per se induces changes of glomerular permselectivity, which may have important pathophysiological implications during conditions of proteinuria.

Albumins↗
PubMed1994

Transport of macromolecules across microvascular walls: the two-pore theory.

In this review we summarized the evidence favoring the concept that the major plasma proteins are passively transported across vascular walls through water-filled pathways by means of convection and diffusion. With regard to solute transport, a majority of microvascular walls seems to show a bimodal size selectivity. This implies the presence of a high frequency of functional small pores, restricting proteins, and an extremely low number of non-size-selective pathways, permitting the passage of macromolecules from blood to tissue, here denoted large pores. We discussed the general behavior of such a heteroporous system. A major consequence of two-pore heteroporosity is that large-solute transport must mainly occur due to convection through large pores at low filtration rates, that is, at normal or even zero lymph flows. Indeed, convection must be the predominating transport mode for most solutes across large pores when the net filtration rate is zero. Under these (transient) conditions, the convective leak of macromolecules across large pores will be counterbalanced by absorption of essentially protein-free fluid through protein-restrictive pores. In a heteroporous membrane, proteins can thus be transported by solvent drag across vascular walls in the absence of a net convection. Normally the steady-state transcapillary fluid flow (lymph flow) is about equally partitioned among small and large pores, which makes lymph essentially a "half and half" mixture of protein-free ultrafiltrate and plasma. With increasing fluid flows, however, the plasma filtrate will be progressively diluted, eventually reaching a protein concentration largely in proportion to the fractional hydraulic conductance accounted for by the large pores (alpha L). Under these high lymph flow conditions, not only the large-pore transport but also the small-pore transport (of smaller macromolecules) will become convective. At low lymph flows, however, the small-pore transport of smaller macromolecules is usually mostly diffusive. An important implication of capillary heteroporosity is that single-pore formalism is inadequate for correctly evaluating the capillary sieving characteristics. With the use of homoporous transport formalism, the "lumped" macromolecular PS and sigma will therefore vary as a function of transcapillary fluid flow (Jv). However, it is approximately correct to use single-pore formalism for conditions when Jv is very high during steady state. Thus, if minimal sieving coefficients can be measured for macromolecules, then these values will accurately reflect (1 - sigma).(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1994

Pathophysiological description of the ultrastructural changes of the peritoneal membrane during long-term continuous ambulatory peritoneal dialysis.

Some of the patients on continuous ambulatory peritoneal dialysis (CAPD) develop with time on treatment an increased transperitoneal transport of small solutes, implying that glucose is more rapidly absorbed from the dialysate. Hence, the dialysate/serum crystalloid osmotic gradient dissipates at a faster rate, so that ultrafiltration failure may result. The pathophysiological correlates to these changes are not well understood. However, it seems that with time on CAPD, there are changes in the submesothelial interstitium, affecting both the ground substance and spacing and orientation of collagen fibers. There may also be mesothelial alterations with patchy shedding of the cells. The present article discusses these changes in terms of a modified three-pore model of peritoneal permeability. In this model, the capillary walls act as a major barrier for solutes ranging in size from inulin (molecular radius 14 A) to macromolecules (molecular radius > 30 A). However, for solutes smaller than inulin both capillary wall and insterstitium contribute to the blood-peritoneum transport impedance. The increased small-solute exchange sometimes occurring in long-term CAPD can be explained either by recruitment of vascular surface area, due, e.g., to an increased capillarization of the peritoneal membrane with time, or, more likely, a drop in the interstitial transport resistance to small solutes. The latter possibility is supported by the often more pronounced increase in the transperitoneal transfer of small solutes than that of macromolecules over time in CAPD.

Biological Transport↗
PubMed1993

Osmotic barrier properties of the rat peritoneal membrane.

In this study the osmotic barrier characteristics of the rat peritoneal membrane were investigated. Fluid movements between the peritoneal cavity and the blood were measured following instillation of isotonic saline (control) and hypertonic solutions of NaCl, glucose, sucrose, raffinose and myoglobin (test solutions). Moreover, 5 and 8% albumin in NaCl were investigated. Osmotic transients were assessed using a simple volume recovery technique. Peritoneal osmotic conductances (i.e. products of peritoneal hydraulic conductances [LpS] and solute reflection coefficients [sigma]) were calculated from the differences in the rates of peritoneal fluid loss and in osmotic pressures between test solutions and the isotonic saline control solution. The osmotic conductance to glucose was estimated to be 1.63 microliters min-1 mmHg-1 m-2 and that for albumin to be 59.6 microliters min-1 mmHg-1 m-2. Assuming an albumin sigma of 0.9, the sigma of glucose was estimated to be 0.025, in accordance with previous measurements for the cat peritoneal membrane. The osmotic conductances assessed here were compatible with an 'overall' peritoneal equivalent small pore radius of 47-48 A, but could also be fitted to a three-pore model of peritoneal permselectivity, including a transcellular (ultra-small pore) pathway and a large pore pathway. The great discrepancy between peritoneal sigma for small solutes and that for albumin obtained in this study indicates that small solute reflection coefficients are close to zero while that for albumin is not far from unity. Furthermore, the peritoneal hydraulic conductance (ultrafiltration coefficient) is large enough to allow for a substantial absorption of fluid directly into the plasma when the crystalloid osmotic pressures in blood and peritoneal dialysate are in equilibrium.

Albumins↗
PubMed1993

A three-pore model of peritoneal transport.

The three-pore model of peritoneal transport treats the capillary membrane as a primary barrier determining the amount of solute that transports to the interstitium and the peritoneal cavity. According to the three-pore model, the principal peritoneal exchange route for water and water-soluble substances is a protein-restrictive pore pathway of radius 40-55 A, accounting for approximately 99% of the total exchange (pore) area and approximately 90% of the total peritoneal ultrafiltration (UF) coefficient (LpS). For their passage through the peritoneal membrane proteins are confined to so-called "large pores" of radius approximately 250 A, which are extremely few in number (0.01% of the total pore population) and more or less nonrestrictive with respect to protein transport. The third pathway of the three-pore model accounts for only about 2% of the total LpS and is permeable to water but impermeable to solutes, a so-called "water-only" (transcellular?) pathway. In contrast to the classical Pyle-Popovich (P&P) model, the three-pore model can predict with reasonable accuracy not only the transport of water and "small solutes" (molecular radius 2.3-15 A) and "intermediate-size" solutes (radius 15-36 A), but also the transport of albumin (radius 36 A) and larger molecules across the peritoneal membrane. The model operates with reflection coefficients(a) (sigma's) for small solutes < 0.1. These are approximately one order of magnitude lower than the sigma's in the P&P model. Furthermore, the peritoneal LpS is one order of magnitude higher than in the P&P model.(ABSTRACT TRUNCATED AT 250 WORDS)

Biological Transport↗
PubMed1992

Glomerular permselectivity is dependent on adequate serum concentrations of orosomucoid.

Orosomucoid, or alpha 1-acid glycoprotein, a serum protein known to be an "acute phase reactant" has recently been shown to be needed for the maintenance of normal capillary permeability in skeletal muscle and mesentery. Therefore, we were interested in studying whether the glomerular capillary wall is affected by orosomucoid as well. For this purpose, left and right kidneys from nine rats (group A) were isolated and perfused in situ and in parallel using separate solutions of human albumin (1.8% in Tyrode), differing in their content of orosomucoid, one containing 0.21 g/liter, the other less than 0.005 g/liter. The temperature was kept at 8 degrees C in order to minimize tubular reabsorption of fluid and albumin. The two kidneys showed identical and stable vascular resistances during the experiments. Also the glomerular filtration rates (GFR) were stable between 30 and 33 ml/min/100 g kidney. Initially, the two kidneys showed similar fractional albumin clearance (theta) values of approximately 0.003. However, in the "absence" of orosomucoid theta increased to become four- to fivefold higher in the test kidney than in the control kidney at the end of the 1 1/2 hour experiment. This difference was observed in all rats, suggesting that orosomucoid is needed also for the maintenance of the glomerular permselectivity. In a separate group of eight animals (group B), orosomucoid-containing albumin solutions were used in parallel with horse serum solutions to perfuse the two kidneys of each rat, at 8 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗