TY - JOUR
T1 - Assessment of the size selectivity of peritoneal permeability by the restriction coefficient to protein transport
AU - Krediet, Raymond T.
AU - Barreto, Deirisa Lopes
AU - van Diepen, Anouk T. N.
N1 - Funding Information: None. The author(s) received no financial support for the research, authorship, and/or publication of this article. Publisher Copyright: © The Author(s) 2022.
PY - 2022/7
Y1 - 2022/7
N2 - Transport of serum proteins from the circulation to peritoneal dialysate in peritoneal dialysis patients mainly focused on total protein. Individual proteins have hardly been studied. We determined serum and effluent concentrations of four individual proteins with a wide molecular weight range routinely in the standardised peritoneal permeability analysis performed yearly in all participating patients. These include β2-microglobulin, albumin, immunoglobulin G and α2-macroglobulin. The dependency of transport of these proteins on their molecular weight and diffusion coefficient led to the development of the peritoneal protein restriction coefficient (PPRC), which is the slope of the relation between the peritoneal clearances of these proteins and their free diffusion coefficients in water, when plotted on a double logarithmic scale. The higher the PPRC, the more size restriction to transport. In this review, we discuss the results obtained on the PPRC under various conditions, such as effects of various osmotic agents, vasoactive drugs, peritonitis and the hydrostatic pressure gradient. Long-term follow-up of patients shows an increase of the PPRC, the possible causes of which are discussed. Venous vasculopathy of the peritoneal microcirculation is the most likely explanation.
AB - Transport of serum proteins from the circulation to peritoneal dialysate in peritoneal dialysis patients mainly focused on total protein. Individual proteins have hardly been studied. We determined serum and effluent concentrations of four individual proteins with a wide molecular weight range routinely in the standardised peritoneal permeability analysis performed yearly in all participating patients. These include β2-microglobulin, albumin, immunoglobulin G and α2-macroglobulin. The dependency of transport of these proteins on their molecular weight and diffusion coefficient led to the development of the peritoneal protein restriction coefficient (PPRC), which is the slope of the relation between the peritoneal clearances of these proteins and their free diffusion coefficients in water, when plotted on a double logarithmic scale. The higher the PPRC, the more size restriction to transport. In this review, we discuss the results obtained on the PPRC under various conditions, such as effects of various osmotic agents, vasoactive drugs, peritonitis and the hydrostatic pressure gradient. Long-term follow-up of patients shows an increase of the PPRC, the possible causes of which are discussed. Venous vasculopathy of the peritoneal microcirculation is the most likely explanation.
KW - Convection
KW - diffusion
KW - peritoneal dialysis patients
KW - peritoneal transport
KW - restriction coefficient
KW - serum proteins
KW - size selectivity
UR - http://www.scopus.com/inward/record.url?scp=85124245975&partnerID=8YFLogxK
U2 - https://doi.org/10.1177/08968608221075102
DO - https://doi.org/10.1177/08968608221075102
M3 - Review article
C2 - 35102776
SN - 0896-8608
VL - 42
SP - 335
EP - 343
JO - Peritoneal Dialysis International
JF - Peritoneal Dialysis International
IS - 4
ER -