腹膜透析における溶質の反発現象

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Recently peritoneal dialysis is renewed by the popularity of continuous ambulatory peritoneal dialysis (CAPD). In CAPD peritoneal dialysis solution may be left in the peritoneal cavity for 4 to 12 hrs prior to drainage. There are many questions about the ultrafiltration and the transport processes of solutes in the long dwelling. So a mathematical model of the peritoneal dialysis system is essential to the analysis of the kinetics of solutes and fluids. Peritoneal membrane is heteroporous and mosaic but our approach considers such structural detail explicitly idealized homoporous membrane.<BR>In 5 patients undergoing peritoneal dialysis, 1.5% and 4.25% dextrose dialysis solutions containing RISA were instilled and dwelled for 6 hrs respectively. In the dwelling period 10 ml of dialysis solutions were sampled serially. The samples of dialysis solutions and serum were analysed the concentrations of solutes and <SUP>131</SUP>I. We could calculate the mass transfer area coefficient, the reflection coefficient and so on, solving the equations for volume flux and solute flow of nonequiliblium thermodynamics. Peritoneal ultrafiltration to dialysis solution stops and reabsorption starts while the osmotic pressure of dialysis solution is higher than that of serum. In each case the reflection coefficient of sodium is more than those of glucose and urea.<BR>We conclude that the dialysis solution might be reabsorbed by the sodium gradient between dialysis solution and serum despite the opposite higher gradient of glucose.
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腹膜透析における溶質の反発現象

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