Document Detail

Role of lymphatics in peritoneal dialysis.
MedLine Citation:
PMID:  1308682     Owner:  NLM     Status:  MEDLINE    
There is a renewed interest in understanding the precise role of lymphatics in the ultrafiltration kinetics during peritoneal dialysis. In the normal state, lymphatics draining the peritoneal cavity are the principal means of removal of intraperitoneal isosmotic fluid and macromolecules. During a hypertonic peritoneal dialysis exchange, after peak intraperitoneal volume is achieved, fluid removal proceeds at an almost linear rate, causing intraperitoneal fluid volume to reduce. The isosmotic fluid removal from the peritoneal cavity could occur through the microcirculatory capillaries or through the lymphatic capillaries draining the peritoneal cavity. Animal and human studies suggest that this fluid loss occurs primarily through lymphatics. The two indirect methods of lymph flow measurements, plasma appearance and peritoneal disappearance of tracer colloid, show conflicting results. Although direct measurement of lymph flow rates through cannulation of mediastinal lymph vessels in animals suggests a significant flow through the lymph channels in response to intraperitoneal fluid instillation, lymph flow modification at the lymph node level may prevent use of this technique to assess the precise role played by lymphatics in fluid kinetics during peritoneal dialysis. By analogy with ascites and by extrapolation from previous studies of drain volumes after infusion of isotonic and hypertonic solutions, the average daily lymph absorption rate during CAPD may be predicted to be at least 1 liter per day.
R Khanna; R Mactier
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Blood purification     Volume:  10     ISSN:  0253-5068     ISO Abbreviation:  Blood Purif.     Publication Date:  1992  
Date Detail:
Created Date:  1993-10-14     Completed Date:  1993-10-14     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8402040     Medline TA:  Blood Purif     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  163-72     Citation Subset:  IM    
University of Missouri, Columbia 65212.
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MeSH Terms
Lymphatic System / physiology*
Peritoneal Cavity
Peritoneal Dialysis*
Reference Values

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