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- W2602246341 abstract "Introduction and Objectives: Uremic toxins may be distributeddifferentially within body fluid compartments. Microdialysisstudies using low molecular weight cut off catheters during dialysissuggest a discrepancy between plasma and interstitial urea kinetics.High molecular weight cut off (HMWCO) catheters will enablesimultaneous capture of interstitial urea and larger toxins but perfusateloss and unreliable analyte recovery limit their use. We compareddextran 40 to standard perfusing fluid (Ringer?s solution) ininterstitial microdialysis with HMWCO catheters in uremic subjects.Methods: Two HMWCO microdialysis catheters were inserted intothe subcutaneous interstitium of 2 healthy controls and perfused withstandard fluid. A third control and 2 peritoneal dialysis patients wereperfused with dextran 40. Flow rate was increased stepwise from 0.3to 5 ?L/mn. Dialysate recovery was compared to expected recovery.Urea concentrations in the dialysate were measured and plottedagainst flow rates to determine interstitial concentrations. Results:Dialysate recovery: 24 samples were collected using dextran 40 and16 samples using standard fluid.There was significant perfusate losswhen standard fluid was used, especially at lower flow rates of 0.3to 1?L/mn. Dialysate recovery averaged 13.7 ?L compared to anexpected 36 ?L (p = 0.003). Meanwhile, dialysate yield with dextran40 averaged 67.52 ?L compared to an expected 64.5 ?L (p = 0.82).Dialysate yield with dextran 40 was significantly higher than yieldwith standard fluid for all flow rates (p < 0.0001). Urea Recoveryand Interstitial Urea: Measured urea from standard fluid dialysateshowed no correlation with perfusion rate, hence determination ofrelative recovery and interstitial urea was not possible. Conversely,with dextran 40, dialysate urea concentration was inversely proportionalto flow rate. The y-intercept on a graph of concentration against flow gave the interstitial urea concentration. This was always closeto the theoretical interstitial urea, i.e. close to plasma urea and to theurea concentration at very low flow rates. Relative recovery of ureaat various flows could hence be determined. Conclusion: Due togood dialysate yield and reliable analyte recovery, dextran 40 enablesmicrodialysis with HMWCO catheters to study small and large uremictoxins in the interstitium." @default.
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- W2602246341 date "2009-09-19" @default.
- W2602246341 modified "2023-09-24" @default.
- W2602246341 title "Good Microdialysate Yield and Reliable Urea Recovery Using Dextran 40 in Interstitial Microdialysis in Uremia" @default.
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