Burdiel L G, Jiménez A, Martin-Malo A, Castillo D, Rodriguez M, Alvarez M A, Aljama P
Hospital Reina Sofía, University of Córdoba, Spain.
Perit Dial Int. 1993;13 Suppl 2:S67-9.
The osmotic gradient is the main driving force for ultrafiltration (UF) in continuous ambulatory peritoneal dialysis (CAPD). Depending on glucose absorption, its changes over a period of time could influence the plasma refilling rate. The aim of this study was to evaluate the influence of changes in the plasma refilling rate obtained by dialysates of different osmolalities upon the rate of UF. Stable CAPD patients were studied twice during a 4-hour exchange 2 weeks apart with dialysate containing 1.5% and 4.25% glucose, respectively. UF was estimated by the autologous hemoglobin dilution method every 30 minutes. Hematocrit and colloidosmotic pressure (COP) decrease when using 1.5% glucose dialysate, reflecting a rise in plasma water mediated by the plasma refilling rate. This water shift is greater than the osmotic gradient generated between peritoneal and intravascular compartments as reflected by a low UF rate. However, when the osmotic gradient increases by means of 4.25% glucose dialysate, the plasma refilling rate is efficiently counter-balanced by UF.
渗透梯度是持续性非卧床腹膜透析（CAPD）中超滤（UF）的主要驱动力。根据葡萄糖吸收情况，其在一段时间内的变化可能会影响血浆再充盈率。本研究的目的是评估不同渗透压的透析液所获得的血浆再充盈率变化对超滤率的影响。对稳定的CAPD患者分别使用含1.5%和4.25%葡萄糖的透析液，在相隔2周的4小时换液期间各研究两次。每30分钟通过自体血红蛋白稀释法估算超滤量。使用1.5%葡萄糖透析液时，血细胞比容和胶体渗透压（COP）降低，这反映了由血浆再充盈率介导的血浆量增加。这种水的转移大于腹膜和血管腔室之间产生的渗透梯度，这表现为超滤率较低。然而，当通过4.25%葡萄糖透析液增加渗透梯度时，超滤可有效平衡血浆再充盈率。
