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NDT Advance Access originally published online on May 25, 2008
Nephrology Dialysis Transplantation 2008 23(7):2120-2123; doi:10.1093/ndt/gfn298
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Water and solute transport in peritoneal dialysis: models and clinical applications

Olivier Devuyst and Eric Goffin

Division of Nephrology, Université catholique de Louvain Medical School, B-1200 Brussels, Belgium

Correspondence and offprint requests to: Olivier Devuyst, Division of Nephrology, Université catholique de Louvain, 10 Avenue Hippocrate, B-1200 Brussels, Belgium. Tel: +32-2-764-54-53; Fax: +32-2-764-54-55; E-mail: olivier.devuyst@uclouvain.be

Keywords: aquaporin; distributed model; glycocalyx; peritoneal transport; three-pore model

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   Introduction
 
The physiology of water and solute transport across the peritoneal membrane during peritoneal dialysis (PD) has been widely studied during the last 30 years. The peritoneum can be viewed as a semi-permeable, heteroporous membrane containing three major components: a monolayer of mesothelial cells; an interstitial tissue containing fibroblasts, macrophages and a conjunctival matrix; and a network of capillaries. It is now commonly accepted that the endothelium lining the peritoneal capillaries represents the main barrier to water and solute transport during PD [1]. Diffusion is the main mode of transport for small solutes (e.g. urea, creatinine, etc. from blood to the dialysate and glucose in the opposite direction) whereas higher molecular weight solutes (e.g. albumin, immunoglobulins, etc.) are transported by convection and water flow is driven by osmosis [1]. Only the perfused membrane in contact with the dialysate participates in solute and fluid transport. Therefore, the effective . . . [Full Text of this Article]

The three-pore model
Membrane versus distributed models
A role for the glycocalyx?
Evaluation of the peritoneal transport: back to patients

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