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Dryad

Effects of fluid overload on water and solute removal during peritoneal dialysis in Sprague-Dawley rats

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Aug 29, 2024 version files 100.58 KB

Abstract

Fluid overload is very common in patients treated with peritoneal dialysis. However, it is as yet unknown whether fluid overload per se affects the dialysis process in terms of the removal of water and small solutes. Here we conducted experiments in thirty-one Sprague-Dawley rats divided into a control group (n=10), one group fluid overloaded with saline 22 mL/kg (n=10) and one group fluid overloaded with 4% albumin 22 mL/kg during the course of thirty minutes. After fluid overload (or a 30 min rest period for the control group), peritoneal dialysis was performed for 120 min utilizing a fill volume of 20 mL and 1.5% glucose fluids. We used 125I-albumin to closely monitor alterations in intraperitoneal volume during the course of the peritoneal dialysis treatment. Subsequently, we analyzed data using the three pore model to determine the underlying mechanisms by quantitating the amount of water transferred across each set of pores. We found sustained increments in water removal during peritoneal dialysis in fluid overloaded animals compared to control animals. The majority of the increased water transfer in fluid overloaded animals was found to occur across interendothelial small pores, either as a result of an increased hydrostatic pressure gradient across the peritoneal membrane (4% albumin) or a reduced plasma oncotic pressure (normal saline). Taken together, these findings indicate that fluid status should be taken into account when evaluating water removal in patients on peritoneal dialysis.