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The passage of THAM across the peritoneum during dialysis
Author(s) -
Nahas Gabriel G.,
Gjessing Jon,
Giroux Jacques J.,
Verosky Mariagnes,
Mark Lester C.
Publication year - 1965
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt196565560
Subject(s) - peritoneal dialysis , urine , chemistry , excretion , dialysis , diuresis , limiting , sodium , medicine , chromatography , anesthesia , surgery , biochemistry , renal function , mechanical engineering , organic chemistry , engineering
The use of THAM during peritoneal dialysis for the extraction of CO 2 , and weak acids in dogs was compared with other dialyzing media. The rapid passage of THAM across the peritoneum is a limiting factor and to avoid reaching toxic levels, the total amount administered of a 0.075M THAM dialysate should not exceed 22 mM per kilogram per 24 hours. Dialysate pR and THAM concentration fell rapidly during the first 30 minutes and then more gradually, while dialysate CO 2 , content increased markedly, THAM dialysate acting as a “C0 2 trap.” After 3 hours 47 per cent of the THAM administered was excreted in the urine and there was a moderate diuresis of alkaline urine. After six 30 minute periods of dialysis the rate of passage of pentobarbital into the dialysate was three times greater with THAM solution than with Ringer solution and more than one and one half times greater than with NaHC0 3 . Comparable results for the three media were obtained during the extraction of phenobarbital. The amount of sodium salicylate extracted into the three dialyzing media was similar, but the production of an alkaline urine with THAM administration enhanced salicylate excretion. Three times more salicylate was excreted in the urine during THAM administration than with Ringer solution and one and one half times more than with NaHCO 3 . Peritoneal dialysis with THAM should have clinical applications for the removal of exogenous or endogenous weak acids.