In conclusion, peritoneal rest improves ultrafiltration in rats by reducing the hyperpermeability of glucose. In addition, peritoneal rest reduced the degree of peritoneal membrane thickening, suggesting that the structural changes caused by peritoneal dialysis and simulated peritonitis are reversible. Further investigation is needed to examine the
The peritoneal membrane undergoes significant changes in structure during long-term continuous ambulatory peritoneal dialysis (CAPD). These changes involve both the mesothelial and intersti tial portions of the peritoneal membrane (1) and affect the transperitoneal solute exchange. Over time on CAPD, some patients develop a hyperpermeability of the peritoneal membrane to small solutes. This situation leads to a more rapid dissipation of the glucose osmotic gradient and a relative loss of ultrafiltration (2). Ultrafiltration loss is one of the major causes of withdrawal from long-term peritoneal dialysis (3). Peritoneal rest by using temporary hemodialysis for a month has been reported to be of benefit for type I ultrafiltration failure: that is, for patients whose poor fluid removal is due to excess absorption of the glucose (4). However, the relationship between changes in peritoneal permeability and peritoneal morphology during peritoneal rest has not been previously reported. Therefore, the aim of the present study was to evaluate the effects of peritoneal rest on peritoneal transport and morphology using a rat model of peritoneal dialysis.
It was concluded that after an episode of severe peritonitis that required Tenckhoff catheter removal, only a small group of patients could return to peritoneal dialysis.