Influence of Phosphatidylcholine on Lymphatic Absorption during Peritoneal Dialysis in the Rat

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Abstract
The mechanism whereby i.p. administration of phosphatidylcholine increases net ultrafiltration and solute clearances after long-dwell exchanges is not established. We performed 4-h exchanges in rats using 4.25% dextrose dialysis solution with and without the addition of 50 mgl L phosphatidylcholine. Net ultrafiltration was enhanced in the treated rats (p < 0.005) by a reduction in cumulative lymphatic absorption (p < 0.01) and without a concurrent increase in total net transcapillary ultrafiltration during the dwell time. Likewise, urea and phosphate clearances with i.p. phosphatidylcholine were enhanced mainly by the increase in the drain volume since serum to dialysate solute concentration ratios did not differ significantly between the treated and control rats. Thus, phosphatidylcholine increases net ultrafiltration and solute clearances in the rat by decreasing lymphatic absorption and without increasing transperitoneal transport of water and solutes into the peritoneal cavity. The uptake of the india ink by the lymphatics of rats who received dialysis exchanges without phosphatidylcholine and the lack of uptake in rats treated with phosphatidylcholine are supported by this observation. Reduction in lymphatic absorption with the addition of phosphatidylcholine to the infused dialysis solution offers an alternative means of enhancing the efficiency of long-dwell peritoneal dialysis.