Numerical investigation of ultrafiltration profiles in peritoneal dialysis with residual icodextrin in blood

Wun Ching Chen, Cheng Ze Gao, Ruey-Jen Yang

Research output: Contribution to journalArticle

Abstract

Icodextrin (ICO) has better biocompatibility and an improved ultrafiltration profile in long-dwell peritoneal dialysis compared to those of glucose. However, the long-term repeated use of a single ICO osmotic agent may cause a change in the peritoneal transport characteristics, leading to a reduction in the ultrafiltration profile. Many studies have shown that such a reduction can be quite significant in some patients. In this study, the factors responsible for this decline are investigated via a series of numerical simulations. The peritoneal transport characteristics and ultrafiltration profile are predicted using a three-pore model. To account for the continuous absorption of ICO from the abdominal cavity during peritoneal dialysis, the three-pore model is modified to accommodate a non-constant concentration of ICO in blood. The simulation results show that the presence of residual ICO in blood results in poorer ultrafiltration behavior. Long-duration and repeated use and exposure to ICO result in a residual concentration of ICO in blood, which changes the mesothelial tissue around the blood capillaries in the peritoneal membrane and causes a reduction in ultrafiltration performance.

Original languageEnglish
Pages (from-to)583-589
Number of pages7
JournalJournal of Medical and Biological Engineering
Volume33
Issue number6
DOIs
Publication statusPublished - 2013

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Dialysis
Ultrafiltration
Peritoneal Dialysis
Blood
Biocompatibility
Glucose
Abdominal Cavity
icodextrin
Tissue
Membranes
Epithelium
Computer simulation

All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Biomedical Engineering

Cite this

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abstract = "Icodextrin (ICO) has better biocompatibility and an improved ultrafiltration profile in long-dwell peritoneal dialysis compared to those of glucose. However, the long-term repeated use of a single ICO osmotic agent may cause a change in the peritoneal transport characteristics, leading to a reduction in the ultrafiltration profile. Many studies have shown that such a reduction can be quite significant in some patients. In this study, the factors responsible for this decline are investigated via a series of numerical simulations. The peritoneal transport characteristics and ultrafiltration profile are predicted using a three-pore model. To account for the continuous absorption of ICO from the abdominal cavity during peritoneal dialysis, the three-pore model is modified to accommodate a non-constant concentration of ICO in blood. The simulation results show that the presence of residual ICO in blood results in poorer ultrafiltration behavior. Long-duration and repeated use and exposure to ICO result in a residual concentration of ICO in blood, which changes the mesothelial tissue around the blood capillaries in the peritoneal membrane and causes a reduction in ultrafiltration performance.",
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Numerical investigation of ultrafiltration profiles in peritoneal dialysis with residual icodextrin in blood. / Chen, Wun Ching; Gao, Cheng Ze; Yang, Ruey-Jen.

In: Journal of Medical and Biological Engineering, Vol. 33, No. 6, 2013, p. 583-589.

Research output: Contribution to journalArticle

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