Pulsed peritoneal dialysis in an experimental rat model: A first experience.

Autor:	Öberg CM; Department of Clinical Sciences Lund, Skåne University Hospital, Lund, Sweden., Wagner S; Baxter International Inc., Hechingen, Germany., Hobro S; Baxter International Inc., Lund, Sweden., Agar BU; Baxter International Inc., Deerfield, IL, USA.
Jazyk:	angličtina
Zdroj:	Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis [Perit Dial Int] 2024 Nov 21, pp. 8968608241299871. Date of Electronic Publication: 2024 Nov 21.
DOI:	10.1177/08968608241299871
Abstrakt:	Background: Peritoneal dialysis (PD) is commonly performed using either intermittent or tidal exchanges, whereas other exchange techniques such as continuous flow PD are little used. Previous research indicated that stirring the intra-peritoneal dialysate markedly increases small solute clearances. Here, we tested the hypothesis that stirring of the dialysate increases small solute clearances by using a novel exchange technique where the dialysate is pulsed back and forth during the treatment without addition of fresh fluid. Methods: PD was performed in anesthetized Sprague-Dawley rats with either no pulsations (20 mL fill volume), 2 mL (10%) pulses (21 mL fill volume), or 5 mL (25%) pulses (22.5 mL fill volume) utilizing a pulse flow rate of 5 mL/min. The higher fill volume for the pulsed treatments compensates for the fact that the average intra-peritoneal volume would otherwise be lower in pulsed treatments. Water and solute transport were closely monitored during the treatment. Results: Net ultrafiltration decreased significantly during pulsed PD with the 25% pulse volume. The 60 min sodium dip was unaltered, whereas the fluid absorption rate was increased for the 25% group. Solute clearances did not significantly differ between groups, except for a slightly lower calcium clearance in the 25% group. Conclusion: Our data indicate that stirring the dialysate using pulsed exchanges does not provide any advantage compared to conventional exchange techniques. In contrast, pulsed treatments had slightly lower ultrafiltration and small solute transport. The present findings may have implications regarding the choice of tidal volume in automated PD, favoring smaller tidal volumes. Competing Interests: Declaration of conflicting interestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: C.M. Öberg reports research grants from Baxter Healthcare and Fresenius Medical Care, and speaker's honoraria from Baxter Healthcare and Boehringer-Ingelheim. C.M. Öberg reports a consultancy agreement with Baxter Healthcare and an advisory or leadership role with the Peritoneal Dialysis International editorial board. All other authors are employees of Baxter International Inc.
Databáze:	MEDLINE
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