CLINICAL STUDIES WITH A NON-VASOACTIVE PERITONEAL-DIALYSIS SOLUTION

Abstract

Topical application of dialysis solution to the rat microcirculation causes a transient vasoconstriction for 2 to 3 min. The clinical importance of this vasoconstriction was assessed by developing a dialysis solution without vasoactive properties. The solution was similar in composition to human extracellular fluid. Its effects on Cur, [peritoneal clearance of urea], Ccr [peritoneal clearance of creatinine] Cin [peritoneal clearance of inulin] and dialysate protein concentration were tested. Compared to commercial solutions, the lower osmolality of the NVS [non-vasoactive solution] resulted in loss of ultrafiltration and decreases in clearances of urea and creatinine. Cin was unchanged, and dialysate protein increased, suggesting a major increase in diffusive transport of larger solutes. Increased diffusive transport of larger solutes with NVS suggests that initial vasoconstriction in the rat could be present and clinically important during peritoneal dialysis in humans.