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This Article Full Text Full Text (PDF) All Versions of this Article: 296/6/H1960    most recent 00121.2009v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Waniewski, J. Articles by Flessner, M. F. PubMed PubMed Citation Articles by Waniewski, J. Articles by Flessner, M. F.

Distributed modeling of osmotically driven fluid transport in peritoneal dialysis: theoretical and computational investigations

¹Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland; ²Divisions of Baxter Novum and Renal Medicine, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; and ³Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi

Submitted 4 February 2009 ; accepted in final form 24 March 2009

Based on a distributed model of peritoneal transport, in the present report, a mathematical theory is presented to explain how the osmotic agent in the peritoneal dialysis solution that penetrates tissue induces osmotically driven flux out of the tissue. The relationships between phenomenological transport parameters (hydraulic permeability and reflection coefficient) and the respective specific transport parameters for the tissue and the capillary wall are separately described. Closed formulas for steady-state flux across the peritoneal surface and for hydrostatic pressure at the opposite surface are obtained using an approximate description of the concentration profile of the osmotic agent within the tissue by exponential function. A case of experimental study with mannitol as the osmotic agent in the rat abdominal wall is shown to be well described by our theory and computer simulations and to validate the applied approximations. Furthermore, clinical dialysis with glucose as the osmotic agent is analyzed, and the effective transport rates and parameters are derived from the description of the tissue and capillary wall.

osmosis; interstitial hydraulic conductivity; capillary hydraulic permeability; reflection coefficient; mathematical modeling