scholarly journals Role of peritoneal cavity lymphatic absorption in peritoneal dialysis

1987 ◽  
Vol 32 (2) ◽  
pp. 165-172 ◽  
Author(s):  
Robert A. Mactier ◽  
Ramesh Khanna ◽  
Zbylut J. Twardowski ◽  
Karl D. Nolph
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Lymphatic Absorption

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

1996 ◽  
Vol 270 (5) ◽  
pp. H1549-H1556 ◽  
Author(s):  
E. R. Zakaria ◽  
O. Simonsen ◽  
A. Rippe ◽  
B. Rippe
Keyword(s):  
Peritoneal Dialysis ◽  
Steady State ◽  
Peritoneal Cavity ◽  
Anterior Abdominal Wall ◽  
Membrane Surface ◽  
Peritoneal Membrane ◽  
Lymphatic Absorption ◽  
Capillary Walls ◽  
Lymphatic Pathways

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.

Role of Diaphragmatic, Visceral, and Parietal Pathways in Peritoneal Fluid Absorption in Rat Peritoneal Dialysis

1996 ◽  
Vol 16 (1_suppl) ◽  
pp. 80-84 ◽  
Author(s):  
Kazuo Kumano ◽  
Kimitoshi Go ◽  
Me He ◽  
Tadasu Sakai
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Absorption Rate ◽  
Ringer Solution ◽  
Fluid Loss ◽  
Fluid Absorption ◽  
Lymphatic Absorption ◽  
Major Route ◽  
Lymphatic Pathway

Assessment was made of the contribution of lymphatic and non lymphatic fluid absorption to net fluid loss from the peritoneal cavity. Diaphragmatic, visceral, and parietal pathways in lymphatics and nonlymphatics were examined using a rat model with adhesion of the diaphragm to the liver, evisceration, these two procedures in combination, and without treatment. In each of these cases, six rats were used, each dialyzed for 180 min with Krebs–Ringer solution. The peritoneal net fluid absorption rate (PNFAR) was determined based on the disappearance of 1251-bovine serum albumin (BSA) from the peritoneal cavity and the lymphatic absorption rate (LAR), was based on the appearance of this albumin in the blood. Seventy-eight percent of net fluid loss occurred via the non lymphatic pathway, primarily through parietal and visceral absorption, and the remaining 22% through the lymphatics, the main pathway being the subdiaphragmatic lymphatics. Nonlymphatic fluid absorption would thus appear to be a major route of fluid loss from the peritoneal cavity in rat peritoneal dialysis.

Role of fenestrated basement membrane in lymphatic absorption from peritoneal cavity

1959 ◽  
Vol 197 (3) ◽  
pp. 551-554 ◽  
Author(s):  
Lane Allen ◽  
Tim Weatherford
Keyword(s):  
Basement Membrane ◽  
Lymph Nodes ◽  
Peritoneal Cavity ◽  
Intraperitoneal Injection ◽  
Entire Population ◽  
Polystyrene Spheres ◽  
Lymphatic Absorption ◽  
Regional Lymph Nodes ◽  
Histological Picture

Polystyrene spheres with a range from chylomicron size up to 30 µ were injected into the peritoneal cavity of mouse, rat and cat, and were recovered from the regional lymph nodes. The largest recovered spheres in the mouse were 16.8 µ in diameter, in the rat and cat 24 µ. Inspection of the entire population of spheres recovered from lymph nodes 48 hours after intraperitoneal injection indicated that most of the fenestrations in the subperitoneal basement membrane are less than 5 µ in the mouse, and more than 5 µ in the cat. Fenestrations in the rat are intermediate between mouse and cat. The deductions as to fenestrations from inspection of the absorbed sphere populations is fairly well in accord with the histological picture in the mouse and cat. Many spheres reach the circulation and the larger ones are filtered out in the lungs, with resulting atelectasis.

Clearance of Tracer Albumin from Peritoneal Cavity to Plasma at Low Intraperitoneal Volumes and Hydrostatic Pressures

1998 ◽  
Vol 18 (5) ◽  
pp. 497-504 ◽  
Author(s):  
Qing Zhu ◽  
Ola Carlsson ◽  
Bengt Rippe
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Fluid Volume ◽  
Free Fluid ◽  
Annual Conference ◽  
Lymphatic Absorption ◽  
Tissue Samples ◽  
Essentially Normal ◽  
Peritoneal Tissue ◽  
Tracer Distribution

Objective To assess the clearance of radiolabeled tracer albumin (RISA) from peritoneal cavity to plasma (CI → P) in rats under essentially “normal” conditions, that is, when intraperitoneal hydrostatic pressure (IPP) is subatmospheric and the intraperitoneal (IP) “free” fluid volume (IPV) is low. Methods A volume of 0.3 mL of RISA was injected IP into anesthetized Wistar rats (wt = 300 g) when the IPV was approximately 2 mL (normal) or the IPV was approximately 10 mL, and IPP was either -1.8 mmHg (normal) or +1.5 mmHg (produced by an external cuff). Plasma samples (25 μL) were obtained repeatedly during the dwell, which lasted 30 300 min, after which the peritoneal cavity was opened to recover the IPV and residuallP RISA activity. The CI → P was assessed as the mass transfer of RISA into plasma, occurring per unit time,-divided by the calculated mean IP RISA concentration (CD). The interstitial RISA space was measured as the mass of RISA accumulated, per unit tissue weight, in peritoneal tissue samples divided by the CD. Results A markedly lower CI → P (2.47 ± 0.67 μL/min), as well as total RISA clearance out of the peritoneal cavity (CI), was found under “normal” conditions (an IPV of approximately 2 mL and an IPP of approximately -1.8 mmHg) compared to the situation during peritoneal dialysis (an IPV of approximately 20 mL and an IPP of +1 mmHg). Furthermore, the interstitial RISA space increased linearly over time even at negative IPPs and at an unchanging peritoneal interstitial fluid volume. At a low (normal) IPV the CI → P did not increase significantly with elevating IPP, and increased only marginally when tracer distribution was improved by artificial vibration of the rats. However the CI → P increased when larger volumes were infused to increase the totallPV. Conclusions It is concluded that the CI → P and CI at low IPPs and IPVs are not as high as during peritoneal dialysis. Increases in CI → P were, however, coupled to increases in IPV. This highlights the importance of the IPV per se and of a sufficient IP tracer distribution for direct lymphatic absorption to be efficient. This study was presented in part at the XVIth Annual Conference on Peritoneal Dialysis, Denver, Colorado, U.S.A., 1997 (33).

The Disappearance of Macromolecules from the Peritoneal Cavity during Continuous Ambulatory Peritoneal Dialysis (CAPD) is Not Dependent on Molecular Size

1990 ◽  
Vol 10 (2) ◽  
pp. 147-152 ◽  
Author(s):  
Raymond T. Krediet ◽  
Dirk G. Struijk ◽  
Gerardus C. M. Koomen ◽  
Fransiscus J. Hoek ◽  
Lambertus Arisz
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Serum Proteins ◽  
Molecular Size ◽  
Gel Permeation Chromatography ◽  
Lymphatic Absorption ◽  
Clearance Ratio ◽  
Dextran 70 ◽  
Dextran Clearance

The transport of macromolecules from the circulation to the peritoneal cavity is a size-selective restricted process, while the transport of these solutes from the peritoneal cavity is probably mainly by lymphatic absorption. If so, it should be independent of molecular size. Therefore, we studied with a clearance technique the disappearance of intra peritoneally administered inulin and polydisperse dextran 70 in nine continuous ambulatory peritoneal dialysis (CAPD) patients and compared the results with the simultaneously measured appearance clearance of serum proteins. Using gel permeation chromatography 18 dextran fractions with different molecular radii could be analyzed. Inulin clearance (2.94 mL/min) was higher than total dextran clearance (1.30 mL/min). The maximal dextran concentration in all dialysate samples was found in the 50.4 Å fraction. The clearances of the dextran fractions were the same for different molecular sizes. All disappearance clearances were higher than the appearance clearances: the protein/dextran clearance ratio ranged from 0.15 for albumin/36 Å to 0.04 for alpha2-macroglobulin/91 Å. This confirms that the appearance of a macromolecule, but not its disappearance is dependent on molecular size. It is concluded that the disappearance of macromolecules from the peritoneal cavity is mainly a size independent convective process, possibly by lymphatic uptake. This implies that total dextran 70 clearance can be used for measurement of lymphatic absorption in CAPD patients.

Influence of Phosphatidylcholine on Lymphatic Absorption during Peritoneal Dialysis in the Rat

1988 ◽  
Vol 8 (3) ◽  
pp. 179-186 ◽  
Author(s):  
Robert A. Mactier ◽  
Ramesh Khanna ◽  
Zbylut J. Twardowski ◽  
Harold Moore ◽  
Karl D. Nolph
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Dwell Time ◽  
Solute Concentration ◽  
Lymphatic Absorption ◽  
India Ink ◽  
Dialysis Solution ◽  
Alternative Means ◽  
And Control ◽  
Concentration Ratios

The mechanism whereby i.p. administration of phosphatidylcholine increases net ultrafiltration and solute clearances after long-dwell exchanges is not established. We performed 4-h exchanges in rats using 4.25% dextrose dialysis solution with and without the addition of 50 mgl L phosphatidylcholine. Net ultrafiltration was enhanced in the treated rats (p < 0.005) by a reduction in cumulative lymphatic absorption (p < 0.01) and without a concurrent increase in total net transcapillary ultrafiltration during the dwell time. Likewise, urea and phosphate clearances with i.p. phosphatidylcholine were enhanced mainly by the increase in the drain volume since serum to dialysate solute concentration ratios did not differ significantly between the treated and control rats. Thus, phosphatidylcholine increases net ultrafiltration and solute clearances in the rat by decreasing lymphatic absorption and without increasing transperitoneal transport of water and solutes into the peritoneal cavity. The uptake of the india ink by the lymphatics of rats who received dialysis exchanges without phosphatidylcholine and the lack of uptake in rats treated with phosphatidylcholine are supported by this observation. Reduction in lymphatic absorption with the addition of phosphatidylcholine to the infused dialysis solution offers an alternative means of enhancing the efficiency of long-dwell peritoneal dialysis.

Accumulation of Omental Mast Cells during Peritoneal Dialysis

2001 ◽  
Vol 21 (3_suppl) ◽  
pp. 373-376 ◽  
Author(s):  
Mohammad Zareie ◽  
Liesbeth H.P. Hekking ◽  
Bas A.J. Driesprong ◽  
Piet M. Ter Wee ◽  
Robert H.J. Beelen ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Mast Cells ◽  
Blood Vessels ◽  
Peritoneal Cavity ◽  
Chronic Exposure ◽  
Control Group ◽  
Clear Correlation ◽  
Access Port ◽  
Peritoneal Mast Cells

Objective New vessel formation has been reported in various tissues during peritoneal dialysis (PD). In that line, mast cells can produce factors such as tryptase, chymase, or basic fibroblast growth factor that might contribute to the formation of new vessels. In the present study, the association of mast cells with neovascularization during PD was investigated. Methods Rats received daily 10 mL infusions of conventional 3.86% glucose-containing PD fluid over a 10-week period. The infusions were delivered through a subcutaneously implanted mini access port that was connected by catheter to the peritoneal cavity. Untreated rats served as a control group. The number of blood vessels and of mast cells in the omentum were counted. Also, the number of peritoneal mast cells was determined. Results Chronic exposure to PD fluid resulted in an increased number of mast cells in the omentum. However, no clear correlation was found between the elevated number of omental blood vessels and the number of mast cells in the omentum or in the peritoneal cavity. Conclusions Omental mast cells accumulated dramatically upon exposure to PD fluid. The actual role of accumulated omental mast cells in the induction of angiogenesis during PD should, however, be further investigated.

Pharmacological Reduction of Lymphatic Absorption from the Peritoneal Cavity Increases Net Ultrafiltration and Solute Clearances in Peritoneal Dialysis

Nephron ◽  
1988 ◽  
Vol 50 (3) ◽  
pp. 229-232 ◽  
Author(s):  
Robert A. Mactier ◽  
Ramesh Khanna ◽  
Harold Moore ◽  
Zbylut J. Twardowski ◽  
Karl D. Nolph
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Lymphatic Absorption

scholarly journals Role of the liver in small-solute transport during peritoneal dialysis.

1994 ◽  
Vol 5 (1) ◽  
pp. 116-120
Author(s):  
M F Flessner ◽  
R L Dedrick
Keyword(s):  
Mass Transfer ◽  
Peritoneal Dialysis ◽  
Surface Area ◽  
Peritoneal Cavity ◽  
Distributed Model ◽  
Blood Capillaries ◽  
Peritoneal Surface ◽  
Small Solute ◽  
Good Agreement

Peritoneal dialysis (PD) is dependent on the transport of water and solutes from the blood capillaries within the tissues that surround the peritoneal cavity. Because of their large blood supply and surface area, the viscera have been considered the most important tissues for PD transport. In animals, however, removal of the gastrointestinal tract decreases PD small-solute mass transfer by only 10 to 27%. To investigate the theoretical basis for these observations, a distributed model of peritoneal transport was extended to take into account the transport characteristics of four tissue groups that surround the cavity: the liver, the hollow viscera, the abdominal wall, and the diaphragm. The mass transfer-area coefficient (MTAC) of sucrose for each tissue was calculated from the following: MTAC = ([D(pa)]0.5)A, where D is the effective solute interstitial diffusivity, pa is the solute transcapillary permeability-area per unit tissue volume, and A is the apparent peritoneal surface area of the tissue. Our results for the adult human predict that the MTAC for the liver is comparable to that of all of the other viscera and makes up 43% of the total MTAC for the peritoneal cavity. The predicted MTAC is 4 cm3/min (plasma) or 6 cm3/min (blood), in good agreement with published values. It is concluded that the liver is responsible for a major portion of the small-solute MTAC. This also explains the earlier observations in eviscerated animals whose PD transport was likely preserved by intact livers.

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