Struijk D G, Koomen G C, Krediet R T, Arisz L
Department of Medicine, University of Amsterdam, The Netherlands.
Kidney Int. 1992 Jun;41(6):1668-75. doi: 10.1038/ki.1992.240.
The disappearance rate of intraperitoneally administered macromolecules is often used to calculate lymphatic absorption during CAPD. The possible contribution of local accumulation (trapping) of such solutes in the tissues surrounding the peritoneal cavity, leading to overestimation of lymphatic flow, was investigated in eight CAPD patients. They were studied twice during a four hour dwell, glucose 1.36%, to which polydisperse neutral dextran 70 1 g/liter had been added for measurement of lymphatic flow. After the test on day 1 dextran 130 mg/kg was given intravenously and also dextran 1 g/liter was added to every following dialysis bag until the second test on day 3. This was done to saturate the tissues surrounding the peritoneal cavity and thereby to create a steady state condition. In one patient the dextran administration was continued until a third study was done on day 5. Dextran in serum during day 3 was 1.3 +/- 0.5 g/liter (mean +/- SD). No difference in peritoneal clearance of dextran was found between day 1 and day 3 (1.11 +/- 0.56 versus 0.97 +/- 0.41 ml/min). Also no difference was found between day 1 (0.32), day 3 (0.62), and day 5 (0.42 ml/min). Trapping would have influenced the first but not the second test, as the second time all tissues were saturated with dextran. As the dextran absorption rate remained the same, this indicates that trapping is of no importance and that lymphatic absorption can be measured by the disappearance of a macromolecular marker.
腹腔内给药的大分子物质消失率常被用于计算持续性非卧床腹膜透析（CAPD）期间的淋巴吸收。本研究在8例CAPD患者中，探讨了此类溶质在腹膜腔周围组织中的局部蓄积（截留）导致淋巴流量高估的可能性。在4小时的1.36%葡萄糖透析液停留期间，对患者进行了两次研究，透析液中添加了1 g/L的多分散中性右旋糖酐70以测量淋巴流量。在第1天的测试后，静脉注射130 mg/kg右旋糖酐，并且在随后的每个透析袋中添加1 g/L右旋糖酐，直至第3天进行第二次测试。这样做是为了使腹膜腔周围组织饱和，从而创造一个稳态条件。在1例患者中，右旋糖酐给药持续至第5天进行第三次研究。第3天血清中的右旋糖酐为1.3±0.5 g/L（均值±标准差）。第1天和第3天之间右旋糖酐的腹膜清除率没有差异（1.11±0.56对0.97±0.41 ml/min）。第1天（0.32）、第3天（0.62）和第5天（0.42 ml/min）之间也没有差异。截留会影响第一次测试，但不会影响第二次测试，因为第二次所有组织都已被右旋糖酐饱和。由于右旋糖酐吸收速率保持不变，这表明截留并不重要，并且可以通过大分子标记物的消失来测量淋巴吸收。
