Small Solute Clearance Research Articles

Continuous ambulatory peritoneal dialysis.

The technique of continuous ambulatory peritoneal dialysis was evaluated in nine patients during 136 patient weeks. The major objectives were to see if continuous ambulatory peritoneal dialysis would provide [1] acceptable control of serum chemistries by usual criteria, [2] adequate removal of sodium and water, [3] tolerable protein losses, and [4] a low prevalence of peritonitis with episodes responsive to therapy with continuing continuous ambulatory peritoneal dialysis. Preliminary findings suggest continuous ambulatory peritoneal dialysis represents an effective ambulatory, portable, internal dialysis technique. Larger-solute clearances per week may approach values six times greater than with most hemodialysis techniques. Small-solute clearances approach dialysate flow rate (8.3 ml/min) and are comparable to other dialysis techniques on a weekly basis. Edema is readily controlled and protein losses should be tolerable with adequate protein intake. Peritonitus occurs on the average every 10 weeks but responds to therapy promptly with continuing continuous ambulatory peritoneal dialysis. If the prevalence of peritonitis can be reduced, continuous ambulatory peritoneal dialysis appears to represent a very attractive dialysis technique.

RELATIONSHIP BETWEEN LYMPHATIC AND BLOOD FLOW IN VARIOUS STRUCTURES IN THE ABDOMINAL CAVITY.

Conclusions1. Clearance of small solutes from the mesentery is about 10 times as rapid as clearance of similar materials from muscle. 2. The ratio of clearances of colloidal to diffusible molecules from mesentery is about 2:3 at 29° and decreases to 1:2.5 at 43°C. 3. Experimentally induced increases of capillary filtration, and presumably lymph formation, increase clearance of colloidal material; those diminishing capillary nitration decrease clearance of colloids. 4. Movement of large molecules from injection depots may serve as an index of local lymph flow; clearance of small diffusible molecules measures flow through vessels capable of exchange. 5. Direct determinations of lymph flow rates from the “iliocolic” duct were found to be almost as great as flow from the thoracic duct. However, occlusion of the “iliocolic” duct diminishes thoracic duct flow by only a very small fraction. This paradox can be explained by the existence of connections between abdominal lymphatics and veins.