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Mechanisms of Crystalloid versus Colloid Osmosis across the Peritoneal Membrane

Morelle, Johann; Sow, Amadou; Fustin, Charles André; Fillée, Catherine; Garcia-Lopez, Elvia; Lindholm, Bengt; Goffin, Eric; Vandemaele, Fréderic; Rippe, Bengt LU and Oberg, Carl M. LU , et al. (2018) In Journal of the American Society of Nephrology 29(7). p.1875-1886
Abstract

Background Osmosis drives transcapillary ultrafiltration and water removal in patients treated with peritoneal dialysis. Crystalloid osmosis, typically induced by glucose, relies on dialysate tonicity and occurs through endothelial aquaporin-1 water channels and interendothelial clefts. In contrast, the mechanisms mediating water flow driven by colloidal agents, such as icodextrin, and combinations of osmotic agents have not been evaluated. Methods We used experimental models of peritoneal dialysis in mouse and biophysical studies combined with mathematical modeling to evaluate the mechanisms of colloid versus crystalloid osmosis across the peritoneal membrane and to investigate the pathways mediating water flow generated by the glucose... (More)

Background Osmosis drives transcapillary ultrafiltration and water removal in patients treated with peritoneal dialysis. Crystalloid osmosis, typically induced by glucose, relies on dialysate tonicity and occurs through endothelial aquaporin-1 water channels and interendothelial clefts. In contrast, the mechanisms mediating water flow driven by colloidal agents, such as icodextrin, and combinations of osmotic agents have not been evaluated. Methods We used experimental models of peritoneal dialysis in mouse and biophysical studies combined with mathematical modeling to evaluate the mechanisms of colloid versus crystalloid osmosis across the peritoneal membrane and to investigate the pathways mediating water flow generated by the glucose polymer icodextrin. Results In silico modeling and in vivo studies showed that deletion of aquaporin-1 did not influence osmotic water transport induced by icodextrin but did affect that induced by crystalloid agents. Water flow induced by icodextrin was dependent upon the presence of large, colloidal fractions, with a reflection coefficient close to unity, a low diffusion capacity, and a minimal effect on dialysate osmolality. Combining crystalloid and colloid osmotic agents in the same dialysis solution strikingly enhanced water and sodium transport across the peritoneal membrane, improving ultrafiltration efficiency over that obtained with either type of agent alone. Conclusions These data cast light on the molecular mechanisms involved in colloid versus crystalloid osmosis and characterize novel osmotic agents. Dialysis solutions combining crystalloid and colloid particles may help restore fluid balance in patients treated with peritoneal dialysis.

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Journal of the American Society of Nephrology
volume
29
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7
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12 pages
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American Society of Nephrology
external identifiers
  • scopus:85049395682
ISSN
1046-6673
DOI
10.1681/ASN.2017080828
language
English
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yes
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decd7038-dbf1-4748-bc79-9d205f3ad0fe
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2018-07-13 11:11:05
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2018-11-13 14:22:47
@article{decd7038-dbf1-4748-bc79-9d205f3ad0fe,
  abstract     = {<p>Background Osmosis drives transcapillary ultrafiltration and water removal in patients treated with peritoneal dialysis. Crystalloid osmosis, typically induced by glucose, relies on dialysate tonicity and occurs through endothelial aquaporin-1 water channels and interendothelial clefts. In contrast, the mechanisms mediating water flow driven by colloidal agents, such as icodextrin, and combinations of osmotic agents have not been evaluated. Methods We used experimental models of peritoneal dialysis in mouse and biophysical studies combined with mathematical modeling to evaluate the mechanisms of colloid versus crystalloid osmosis across the peritoneal membrane and to investigate the pathways mediating water flow generated by the glucose polymer icodextrin. Results In silico modeling and in vivo studies showed that deletion of aquaporin-1 did not influence osmotic water transport induced by icodextrin but did affect that induced by crystalloid agents. Water flow induced by icodextrin was dependent upon the presence of large, colloidal fractions, with a reflection coefficient close to unity, a low diffusion capacity, and a minimal effect on dialysate osmolality. Combining crystalloid and colloid osmotic agents in the same dialysis solution strikingly enhanced water and sodium transport across the peritoneal membrane, improving ultrafiltration efficiency over that obtained with either type of agent alone. Conclusions These data cast light on the molecular mechanisms involved in colloid versus crystalloid osmosis and characterize novel osmotic agents. Dialysis solutions combining crystalloid and colloid particles may help restore fluid balance in patients treated with peritoneal dialysis.</p>},
  author       = {Morelle, Johann and Sow, Amadou and Fustin, Charles André and Fillée, Catherine and Garcia-Lopez, Elvia and Lindholm, Bengt and Goffin, Eric and Vandemaele, Fréderic and Rippe, Bengt and Oberg, Carl M. and Devuyst, Olivier},
  issn         = {1046-6673},
  language     = {eng},
  month        = {07},
  number       = {7},
  pages        = {1875--1886},
  publisher    = {American Society of Nephrology},
  series       = {Journal of the American Society of Nephrology},
  title        = {Mechanisms of Crystalloid versus Colloid Osmosis across the Peritoneal Membrane},
  url          = {http://dx.doi.org/10.1681/ASN.2017080828},
  volume       = {29},
  year         = {2018},
}