Mechanisms of Crystalloid versus Colloid Osmosis across the Peritoneal Membrane

Journal of the American Society of Nephrology : JASN
Johann MorelleOlivier Devuyst

Abstract

Background Osmosis drives transcapillary ultrafiltration and water removal in patients treated with peritoneal dialysis. Crystalloid osmosis, typically induced by glucose, relies on dialysate tonicity and occurs through endothelial aquaporin-1 water channels and interendothelial clefts. In contrast, the mechanisms mediating water flow driven by colloidal agents, such as icodextrin, and combinations of osmotic agents have not been evaluated.Methods We used experimental models of peritoneal dialysis in mouse and biophysical studies combined with mathematical modeling to evaluate the mechanisms of colloid versus crystalloid osmosis across the peritoneal membrane and to investigate the pathways mediating water flow generated by the glucose polymer icodextrin.ResultsIn silico modeling and in vivo studies showed that deletion of aquaporin-1 did not influence osmotic water transport induced by icodextrin but did affect that induced by crystalloid agents. Water flow induced by icodextrin was dependent upon the presence of large, colloidal fractions, with a reflection coefficient close to unity, a low diffusion capacity, and a minimal effect on dialysate osmolality. Combining crystalloid and colloid osmotic agents in the same dialysis s...Continue Reading

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Citations

Mar 9, 2019·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Carl M Öberg, Giedre Martuseviciene
Mar 11, 2019·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Ju-Yeh YangKuan-Yu Hung
Jul 15, 2020·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Yi WangNa Liu
Feb 1, 2019·Frontiers in Physiology·Maria Bartosova, Claus Peter Schmitt
Mar 30, 2021·Clinical Kidney Journal·David A Jaques, Andrew Davenport
Mar 9, 2021·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Lucas de J PereiraHugo Abensur
Apr 14, 2021·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Giedre MartusCarl M Öberg
Apr 30, 2021·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Carl M Öberg
Jun 10, 2021·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Olivier Devuyst
Aug 8, 2021·International Journal of Molecular Sciences·Mario BonominiGiovanni Gambaro
Aug 27, 2021·Science Translational Medicine·Rebecca HerzogKlaus Kratochwill
Jan 12, 2022·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Jakob Helman, Carl M Öberg
Jan 13, 2022·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·Kenya SanadaYoichi Ueta

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