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Physiology of the Peritoneum
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KMID : 0360919610040010001
Abstract
Peritoneal membrane consists of three layers: a) the capillary endothelium b) the peritoneal interstitium, c) the mesothelium.
The transport of small molecules take place passively through the intercellular space of the capillary and the mesothelium. Vesicular transport seems to be responsible for the slow passage of large molecules.
Peritoneal dialysis system is lee effective compared to hemodialysis system in terms of clearance of small molecules and blood flow rate. However, this problem is overcome by CAPD with prolonged dwell time.
Moreover peritoneal dialysis is more effective for the clearance of middle molecules than the hemodialysis.
Peritoneal defense depends on two basic mechanisms:
1) disphragmatic lymphatic circulation,
2) resident phagocytic cells.
Peritoneal dialysis destroys this natural defense mechanism by disturbing the lymphatic flow and by dilution of the opsonin in the pritoneal cavity.
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