Ultrafiltration Patterns of Dextran and Hydroxyethylstarch during Long-Dwell Peritoneal Dialysis Exchanges in Nonuremic Rats

Abstract

Commercially available peritoneal dialysis solutions contain glucose as an osmotic agent to obtain ultrafiltration (UF), but are associated with the disadvantage of rapid absorption.^{(1, 2)} This results in loss of UF,^{(3, 4)} and metabolic complications such as obesity and aggravation of lipid abnormalities.⁽⁵⁾ Furthermore, low pH inhibits polymorphonuclear phagocytosis as does the high osmolality of the dialysate solution.⁽⁶⁾ A slowly absorbable osmotic agent might be desirable, especially in patients with poor UF. Osmotic agent with larger molecules have longer duration of UF. Larger molecules would have to be present in high concentrations to achieve adequate osmotic effect, but would have the advantage of being more slowly absorbed. Recently, the advantages and disadvantages of several osmotic agents have been extensively reviewed.^{(7, 8)}