Accuracy of Peritoneal Membrane Solute Reflection Coefficients

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Abstract
Solute reflection coefficients for the peritoneal membrane have been previously estimated from the dependence of dialysate solute concentration (Cd)on time during peritoneal dialysis. The accuracy of such solute reflection coefficients was determined in the present study from computer experiments using the Monte Carlo method. The time dependence of Cdwas first simulated for a 4-hour dwell using a peritoneal membrane model with assumed values of the permeability-area product (PA) and solute reflection coefficient (σ). Values of PA and σ were then estimated using nonlinear regression from the simulated data after adding random errors to the values of Cd· When solute transport was simulated in the dialysate-to-blood direction during a hypertonic exchange, estimates of PA and σ were unbiased but variable. When solute transport was simulated in the blood-to-dialysate direction during a hypertonic exchange, PA and σ estimates were unbiased only for slowly diffusing solutes when random errors of small magnitude were considered. Previously determined values of the solute reflection coefficient for the peritoneal membrane may not be quantitatively accurate.

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