Visceral peritoneum is not essential for solute transport during peritoneal dialysis

Abstract

The importance of visceral peritoneum in determining transperitoneal solute exchange was studied by determining the influence of evisceration on diffusive solute transport during peritoneal dialysis. Three series of experiments were performed in anesthetized New Zealand White rabbits. Series 1 studies compared solute transport rates from eviscerated rabbits (N = 5) with those from sham-operated controls (N = 5). Series 2 studies compared solute transport rates from eviscerated (N = 6) and sham-operated rabbits (N = 5) with application of circumferential abdominal compression to control intraperitoneal pressure and presumably maximize dialysate-peritoneum contact. Series 3 studies compared solute transport rates from sham-operated rabbits (N = 4) with and without applied circumferential abdominal compression. Transperitoneal solute exchange of creatinine and FITC-labeled neutral dextran (15 to 40 A) was equally assessed by both the dialysate to plasma concentration ratio at the end of the exchange and the diffusive permeability-area product of the peritoneum. Evisceration reduced creatinine (P less than 0.001) and dextran (15 to 30 A, P less than 0.05) transport to approximately one quarter that of controls in series 1 rabbits. When circumferential abdominal compression was applied in series 2 rabbits, however, evisceration had no effect on peritoneal solute transport rates. Moreover, circumferential abdominal compression per se had no effect on solute exchange in series 3 experiments. These findings demonstrate that the influence of evisceration on peritoneal solute transport depends on the experimental conditions. These observations further demonstrate that visceral peritoneum is not essential for solute transport during peritoneal dialysis.