Lymphatic Absorption in Continuous Ambulatory Peritoneal Dialysis Patients with Normal and High Transperitoneal Glucose Transport

Abstract

Ultrafiltration (UF) in peritoneal dialysis is induced by the osmotic pressure of the hypertonic dextrose dialysis solution. The progressive loss of peritoneal UF capacity observed in some continuous ambulatory peritoneal dialysis (CAPD) patients is at least partially due to increased peritoneal permeability x area, rapid absorption of glucose from the dialysate, and early dissipation of the osmotic gradient.^(1–6) However, continuous absorption of isotonic and hypertonic intraperitoneal fluid by end lymphatics, located mainly on the undersurface of the diaphragm, also significantly reduces net UF in long-dwell peritoneal dialysis^{(7, 8)} This study compares the role of peritoneal lymphatic absorption in UF kinetics in CAPD patients with normal and high peritoneal solute transport.^{(6, 9)}