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[Transport processes--ultrafiltration in peritoneal dialysis]. 1996

V Nesić, and Z Dimitrijević, and B Stojimirović
Institut za urologiju i nefrologiju Klinikog centra Srbije, Beograd.

In patients with terminal renal failure treated by peritoneal dialysis diffusion and ultrafiltration are used for removal of substances from the blood. Neofiltration is realized via the osmolar gradient, determined by different concentration of glucose and dialysis solutions. Osmotic water transport during peritoneal dialysis is limited. In the course of one exchange of two liters of the dialysate, exponential reduction of glucose levels in the peritoneal fluid ensues against time. Substance of low molecular weight, such as glucose, are resorbed from dialysate reducing the osmotic gradient between blood and dialysis fluid. Two successive phases in the course of exchange lasting for several hours are the main features of ultrafiltration during peritoneal dialysis. The first phase includes positive ultrafiltration, transport of water and soluble substances from the blood into the dialysate. Peritoneal volume increases gradually up to a certain maximum. Time needed to achieve that depends on the glucose concentration in the dialysate and time. The second phase starts when osmotic concentration of peritoneal solution becomes lower than osmotic concentration of the blood due to glucose resorption. It results in negative ultrafiltration, i.e. return of water and soluble substances from dialysis solution back into the blood: The paper reviews the production of concentration haemodialysis solutions at the Department of Pharmacy. Military Medical Academy, Belgrade. The first series of 3400 liters was produced during 1971. It is only 3% of the current production. Ever since, the extent of production and number of new products have increased annually. Today, 2500 lit of five types of solutions for hemodialysis are manufactured weekly at the Institute of Pharmacy. The quality of these solutions is secured by good manufacturing practise, quality control of substances and physico-chemical control of the produced solutions. The Institute of Pharmacy collaborates with the Clinic of Nephrology permanently improving and adjusting the production program.

UI MeSH Term Description Entries
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D010530 Peritoneal Dialysis Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. Dialyses, Peritoneal,Dialysis, Peritoneal,Peritoneal Dialyses
D004573 Electrolytes Substances that dissociate into two or more ions, to some extent, in water. Solutions of electrolytes thus conduct an electric current and can be decomposed by it (ELECTROLYSIS). (Grant & Hackh's Chemical Dictionary, 5th ed) Electrolyte
D005947 Glucose A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. Dextrose,Anhydrous Dextrose,D-Glucose,Glucose Monohydrate,Glucose, (DL)-Isomer,Glucose, (alpha-D)-Isomer,Glucose, (beta-D)-Isomer,D Glucose,Dextrose, Anhydrous,Monohydrate, Glucose
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001202 Ascitic Fluid The serous fluid of ASCITES, the accumulation of fluids in the PERITONEAL CAVITY. Peritoneal Effusion,Peritoneal Fluid,Ascitic Fluids,Effusion, Peritoneal,Fluid, Ascitic,Fluid, Peritoneal,Peritoneal Effusions,Peritoneal Fluids
D001692 Biological Transport The movement of materials (including biochemical substances and drugs) through a biological system at the cellular level. The transport can be across cell membranes and epithelial layers. It also can occur within intracellular compartments and extracellular compartments. Transport, Biological,Biologic Transport,Transport, Biologic
D014462 Ultrafiltration The separation of particles from a suspension by passage through a filter with very fine pores. In ultrafiltration the separation is accomplished by convective transport; in DIALYSIS separation relies instead upon differential diffusion. Ultrafiltration occurs naturally and is a laboratory procedure. Artificial ultrafiltration of the blood is referred to as HEMOFILTRATION or HEMODIAFILTRATION (if combined with HEMODIALYSIS).

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