Ultrafiltration failure in long-term peritoneal dialysis patients is a well-known and important, but poorly-explained complication of the treatment. Transcapillary ultrafiltration consists mainly of small-pore fluid transport and partly of free-water transport. The former is to a large extent dependent on the hydrostatic pressure gradient and on the number of perfused peritoneal microvessels. Free-water transport depends mainly on the crystalloid osmotic gradient. A longitudinal analysis of peritoneal transport has shown a dramatic decrease of net ultrafiltration and small-pore fluid transport after 4 years of peritoneal dialysis. It will be argued that in contrast to common belief, a decrease of osmotically induced water transport cannot be the major contributor to long-term ultrafiltration failure. By exclusion of potential alternatives, the presence of vasculopathy in the peritoneal microcirculation is the most likely explanation. The resulting narrowing of vascular lumina will decrease the hydrostatic pressure gradient and thereby small-pore fluid transport and net ultrafiltration. Deposition of advanced glycosylation end products in peritoneal vessels may be important in the development of vasculopathy. This hypothesis is supported by morphological and functional results of dialysis with "biocompatible" solutions. .
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.5414/CN109596 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Mechanisms underlying the involvement of peritoneal macrophages in the pathogenesis and novel therapeutic strategies for dialysis-induced peritoneal fibrosis.
Front Immunol
January 2025
Department of Nephrology, Second Hospital of Jilin University, Changchun, China.
Long-term exposure of the peritoneum to peritoneal dialysate results in pathophysiological changes in the anatomical organization of the peritoneum and progressive development of peritoneal fibrosis. This leads to a decline in peritoneal function and ultrafiltration failure, ultimately necessitating the discontinuation of peritoneal dialysis, severely limiting the potential for long-term maintenance. Additionally, encapsulating peritoneal sclerosis, a serious consequence of peritoneal fibrosis, resulting in patients discontinuing PD and significant mortality.
View Article and Find Full Text PDFTherapeutic Potential of Oligo-Fucoidan in Mitigating Peritoneal Dialysis-Associated Fibrosis.
Mar Drugs
November 2024
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
Peritoneal dialysis (PD) serves as a home-based kidney replacement therapy with increasing utilization across the globe. However, long-term use of high-glucose-based PD solution incites repeated peritoneal injury and inevitable peritoneal fibrosis, thus compromising treatment efficacy and resulting in ultrafiltration failure eventually. In the present study, we utilized human mesothelial MeT-5A cells for the in vitro experiments and a PD mouse model for in vivo validation to study the pathophysiological mechanisms underneath PD-associated peritoneal fibrosis.
View Article and Find Full Text PDFAdvancements of aquaporin 1 in ultrafiltration failure secondary to peritoneal dialysis.
Pediatr Nephrol
December 2024
Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
For patients undergoing long-term peritoneal dialysis (PD), exposure to biologically incompatible PD solutions and the consequent peritoneal structure change can lead to progressive angiogenesis and fibrosis, and ultimately result in ultrafiltration failure (UFF). Peritoneal transport studies in aquaporin 1 (AQP1) knockout mice indicate that water transport across the peritoneum is mediated by AQP1, which accounts for up to 50% of ultrafiltration. Another recent study on a large cohort of PD patients with kidney failure further substantiated the impact of AQP1 genotype variation on water channel expression in the peritoneal membrane, influencing water transport, ultrafiltration, and patient prognosis.
View Article and Find Full Text PDFThe role of continuous renal replacement therapy in the management of cardiorenal syndrome involving acute myocardial infarction with concomitant pneumonia: case report.
Pan Afr Med J
December 2024
Department of Surgery, Faculty of Medicine, Hasanuddin University, Hasanuddin University Hospital, Makassar, Indonesia.
Acute heart failure is associated with high hospitalization and mortality rates. A strong, independent risk factor for mortality in patients with heart failure is acute kidney injury, and the condition caused by this connection between disturbances in heart function and proper kidney functioning is cardiorenal syndrome (CRS). This case report discusses the role of continuous renal replacement therapy (CRRT) in the management of a CRS case with septic shock due to pneumonia.
View Article and Find Full Text PDFAngiotensin-I-converting enzyme inhibitory peptides from eel () bone collagen: preparation, identification, molecular docking, and protective function on HUVECs.
Front Nutr
December 2024
Key Laboratory of Aquatic Product Processing, Ministry of Agriculture and Rural Affairs, National R&D Center for Aquatic Product Processing, South China Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, China.
Introduction: Hypertension is a chronic cardiovascular disease, which can trigger some disease such as heart failure, loss of vision or kidney. There were various peptides derived from food that are recognized for their ability to inhibit ACE activity, potentially leading to a reduction in blood pressure levels . The primary objective of this research is to discover ACE inhibitory peptides from protein hydrolysates of eel bone collagen (EBCHs).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!