Nolph K D, Miller F, Rubin J, Popovich R
Kidney Int Suppl. 1980 Sep;10:S111-6.
A limited number of peritoneal capillaries involved in solute exchange during peritoneal dialysis and inaccessible stagnant fluid films within the peritoneal interstitium may account for most resistance to solute transport during peritoneal dialysis. The control of small solute concentrations in blood by intermittent peritoneal dialysis will probably always require 30 to 40 hr/week of treatment even with the most rapid cycling devices. Increased understanding of factors that effect the microcirculation of the peritoneum may allow manipulation of protein losses and optimization of the long-term health of the peritoneum but will probably have little impact on the efficiency of small solute transport. CAPD accepts peritoneal dialysis as a low-efficiency system in terms of small solute clearances and yet yields similar weekly clearances to hemodialysis for small solutes by utilizing continuous dialysis. Large solute clearances with CAPD markedly exceed weekly clearances with hemodialysis.
腹膜透析过程中参与溶质交换的腹膜毛细血管数量有限，以及腹膜间质内难以触及的停滞液膜，可能是腹膜透析过程中溶质转运阻力的主要原因。即使使用最快的循环装置，通过间歇性腹膜透析控制血液中小溶质浓度可能仍需要每周治疗30至40小时。对影响腹膜微循环因素的进一步了解，可能有助于控制蛋白质流失并优化腹膜的长期健康状况，但可能对小溶质转运效率影响不大。就小溶质清除率而言，持续性非卧床腹膜透析（CAPD）认为腹膜透析是一种低效系统，但通过持续透析，其小溶质每周清除率与血液透析相似。CAPD的大溶质清除率明显超过血液透析的每周清除率。
