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Am J Physiol Renal Physiol 280: F599-F606, 2001;
0363-6127/01 $5.00
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Vol. 280, Issue 4, F599-F606, April 2001

Transport asymmetry in peritoneal dialysis: application of a serial heteroporous peritoneal membrane model

Daniele Venturoli1,2 and Bengt Rippe1

1 Department of Nephrology, University Hospital of Lund, S-22185 Lund, Sweden; and 2 Istituto di Fisiologia Umana, Università degli Studi di Milano, I-20133 Milan, Italy

The transport of macromolecules during peritoneal dialysis is highly selective when they move from blood to dialysate but nearly completely unselective in the opposite direction. Aiming at describing this asymmetry, we modeled the peritoneal barrier as a series arrangement of two heteroporous membranes. First a three-pore membrane was considered, crossed by small [radius of the small pore (rs) approx  45 Å], large [radius of the large pore (rL) approx  250 Å], and transcellular pores accounting for 90, 8, and 2% to the hydraulic conductance, respectively, and with a corresponding pore area over diffusion distance (A0/Delta x) set to 50,000 cm. We calculated the second membrane parameters by fitting simultaneously the bidirectional clearance of molecules ranging from sucrose [molecular weight = 360, permeating solute radius (ae) approx  5 Å] to alpha 2-macroglobulin (molecular weight = 820,000, aeapprox 90 Å). The results describe a second two-pore membrane with very large pores (rLapprox 2,300 Å) accounting for 95% of the hydraulic conductance, minor populations of small (rsapprox 67 Å) and transcellular pores (3 and 2%, respectively), and an A0/Delta xapprox 65,000 cm. The estimated peritoneal lymph flow is approx 0.3 ml/min. The two membranes can be identified as the capillary endothelium and an extracellular interstitium lumped with the peritoneal mesothelium.

extracellular interstitium; concentration hyperpolarization; composite membranes; pore theory; mathematical model


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