Nesić V, Dimitrijević Z, Stojimirović B
Institut za urologiju i nefrologiju Klinikog centra Srbije, Beograd.
Srp Arh Celok Lek. 1996;124 Suppl 1:159-62.
In patients with terminal renal failure treated by peritoneal dialysis diffusion and ultrafiltration are used for removal of substances from the blood. Neofiltration is realized via the osmolar gradient, determined by different concentration of glucose and dialysis solutions. Osmotic water transport during peritoneal dialysis is limited. In the course of one exchange of two liters of the dialysate, exponential reduction of glucose levels in the peritoneal fluid ensues against time. Substance of low molecular weight, such as glucose, are resorbed from dialysate reducing the osmotic gradient between blood and dialysis fluid. Two successive phases in the course of exchange lasting for several hours are the main features of ultrafiltration during peritoneal dialysis. The first phase includes positive ultrafiltration, transport of water and soluble substances from the blood into the dialysate. Peritoneal volume increases gradually up to a certain maximum. Time needed to achieve that depends on the glucose concentration in the dialysate and time. The second phase starts when osmotic concentration of peritoneal solution becomes lower than osmotic concentration of the blood due to glucose resorption. It results in negative ultrafiltration, i.e. return of water and soluble substances from dialysis solution back into the blood: The paper reviews the production of concentration haemodialysis solutions at the Department of Pharmacy. Military Medical Academy, Belgrade. The first series of 3400 liters was produced during 1971. It is only 3% of the current production. Ever since, the extent of production and number of new products have increased annually. Today, 2500 lit of five types of solutions for hemodialysis are manufactured weekly at the Institute of Pharmacy. The quality of these solutions is secured by good manufacturing practise, quality control of substances and physico-chemical control of the produced solutions. The Institute of Pharmacy collaborates with the Clinic of Nephrology permanently improving and adjusting the production program.
在接受腹膜透析治疗的终末期肾衰竭患者中，扩散和超滤用于从血液中清除物质。新过滤是通过由葡萄糖和透析液不同浓度决定的渗透梯度实现的。腹膜透析过程中的渗透水转运是有限的。在一次两升透析液交换过程中，腹膜液中葡萄糖水平随时间呈指数下降。低分子量物质，如葡萄糖，会从透析液中被重吸收，从而降低血液与透析液之间的渗透梯度。腹膜透析超滤过程的主要特征是持续数小时的交换过程中有两个连续阶段。第一阶段包括正超滤，即水和可溶性物质从血液转运至透析液。腹膜容积逐渐增加直至达到某个最大值。达到该值所需的时间取决于透析液中的葡萄糖浓度和时间。第二阶段始于由于葡萄糖重吸收导致腹膜溶液的渗透浓度低于血液的渗透浓度时。这会导致负超滤，即水和可溶性物质从透析液返回血液。本文回顾了贝尔格莱德军事医学院药学系浓缩血液透析溶液的生产情况。1971年生产了首批3400升，仅占当前产量的3%。从那时起，产量规模和新产品数量逐年增加。如今，药学研究所每周生产2500升五种类型的血液透析溶液。这些溶液的质量通过良好生产规范、物质质量控制和所生产溶液的物理化学控制来保证。药学研究所与肾脏病诊所合作，不断改进和调整生产计划。
