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Albumin‐based Solutions for Peritoneal Dialysis: Investigations with a Rat Model
Author(s) -
Park Min Sun,
Heimbtirger Olof,
Bergström Jonas,
Waniewski Jacek,
Werynski Andrzej,
Lindholm Bengt
Publication year - 1995
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.1995.tb02333.x
Subject(s) - peritoneal dialysis , albumin , dialysis , ultrafiltration (renal) , chemistry , serum albumin , chromatography , urology , medicine , biochemistry
To evaluate albumin, an osmotic agent for peritoneal dialysis, the peritoneal fluid and solute transport were investigated during a 4‐h single cycle peritoneal dialysis with albumin‐based dialysis solutions. Two different albumin solutions were used in 15 normal Sprague‐Dawley rats: isotonic 7.5% albumin solution (ADS 1, n = 7) and a combined 7.5% albumin and 1.36% glucose solution (ADS 2; n = 8). A standard 1.36% Dianeal solution was used to provide control values (n = 6). The rate of the intraperitoneal volume change ( Q v ) was positive during the initial 90 min with ADS 2 and during the initial 60 min with Dianeal 1.36% solution but negative with ADS 1. The peritoneal bulk flow reabsorption rate, Q a , was similar in all three groups. The estimated rate of transcapillary ultrafiltration ( Q u = Q v + Q j was positive with all three solutions throughout the dialysis. With ADS 1, Q u increased gradually during the initial 90 min and then remained stable, but it decreased with ADS 2 and Dianeal 1.36% solution. Q u with ADS 2 did not differ from that with Dianeal 1.36% solution during the initial 60 min, but it was significantly higher during the latter part of dialysis. The value of Q u during the last 2 h of dialysis was 0.026 ± 0.010 and 0.025 ± 0.009 ml/min with ADS 1 and ADS 2, respectively, and it was significantly higher than that with Dianeal 1.36% solution (0.005 ± 0.007 ml/ min; p< 0.017). After 4 h of dialysis, 76.1 ± 10.2 and 78.8 ± 11.1% of the initial amount of albumin remained in the peritoneal cavity with ADS 1 and ADS 2, respectively. Since a positive value of Q u was maintained for at least 4 h during dialysis with the two albumin‐based solutions and was significantly higher after 4 h of dialysis than with the Dianeal 1.36% solution, and since ( Q a ) was similar with the three solutions, the present findings indicate that the differences in the Q v values are due to the differences in the transcapillary ultrafiltration rate ( Q U ). Furthermore, ADS 2, a solution containing both crystalloid and colloid osmotic agents, resulted in higher and more prolonged ultrafiltration than did the conventional glucose solution. After 4 h of dialysis, about 20–25% of the initial amount of albumin was absorbed, indicating that albumin‐based dialysis solutions may compensate for the protein loss into dialysate in continuous ambulatory peritoneal dialysis (CAPD) patients. The results of the present study may provide useful reference data in the evaluation of alternative osmotic agents.