The transport of phosphate between the plasma and dialysate compartments in peritoneal dialysis is influenced by an electric potential difference

Abstract

Six kinetic models of transperitoneal phosphate transport were formulated and validated on the basis of experimental results obtained from 22 non-diabetic patients undergoing peritoneal dialysis. The models were designed to elucidate the presence or absence of diffusive, non-lymphatic convective, and lymphatic convective phosphate transport. Calculations allowed for a 20% protein binding of phosphate. The validation procedure demonstrated that only diffusive and non-lymphatic convective phosphate transport mechanisms were identifiable. A lymphatic convective phosphate transport mechanism was not identifiable. Furthermore, it was demonstrated that the electrochemical gradient between plasma water and dialysate favours the diffusive phosphate transport, and both electric and chemical potentials must be taken into account in calculations of the transperitoneal phosphate transport.