Semipermeability imparted by surface-active phospholipid in peritoneal dialysis

Chen, Y., Burke, J.R. and Hills, B.A. (2002) Semipermeability imparted by surface-active phospholipid in peritoneal dialysis. Peritoneal Dialysis International, 22 3: 380-385.

Author Chen, Y.
Burke, J.R.
Hills, B.A.
Title Semipermeability imparted by surface-active phospholipid in peritoneal dialysis
Journal name Peritoneal Dialysis International   Check publisher's open access policy
ISSN 1718-4304
Publication date 2002-05
Sub-type Article (original research)
Volume 22
Issue 3
Start page 380
End page 385
Total pages 6
Place of publication Toronto, Ont., Canada
Publisher Multimed
Collection year 2002
Language eng
Subject C1
321012 Nephrology and Urology
730115 Urogenital system and disorders
Formatted abstract
It has previously been demonstrated that a lining of surface-active phospholipid (SAPL) is reversibly bound (adsorbed) to normal peritoneal mesothelium. The lining acts as a boundary lubricant and release (anti-stick) agent preserving mechanical integrity of the epithelial surface. In a review of clinical trials on the use of SAPL (akin to surfactant) to restore ultrafiltration (UF) in patients on peritoneal dialysis (PD), speculation is that, by adsorption, the SAPL lining might also be imparting the semipermeability vital for UF.

To evaluate the hypothesis, SAPL harvested from the spent dialysate of 5 patients with normal UF was deposited onto a porous, inert medium, and the resulting 7 membranes were clamped in an Ussing chamber used as an osmometer.

With every membrane, a clinical concentration of glucose (2.5%) was able to induce a statistically significant osmotic pressure when dialyzed against saline. We also demonstrated how synthetic SAPL-in the form of dipalmitoyl phosphatidylcholine (DPPC) and an admixture of DPPC with phosphatidylglycerol (PG) called artificial lung-expanding compound (ALEC)-imparts greater osmotic pressure in proportion to an increasing glucose gradient. Our findings prove that human peritoneal SAPL has the physical capability to impart semipermeability when adsorbed to a surface.


As a lipid lining, adsorbed SAPL could also explain the high permeability of the natural membrane to lipophilic substances in PD. Administered as a very fine powder or as a solution in a lipid solvent, ALEC offers a potential treatment for restoring UF, if applied during the interdialytic interval. In various physical forms, ALEC and DPPC have both been widely used for two decades with complete safety in the treatment of respiratory distress syndrome in newborns. The question of formulation of exogenous SAPL in restoring UF is discussed as a complex physicochemical compromise between the higher surface activity of saturated phosphatidylcholine and its lower solubility in water.
Keyword Urology & Nephrology
Exogenous Surfactant
Osmotic Pressure
Replenishment In Peritoneal Dialysis
Semi-permeable Membrane
Surface-active Phospholipid
Lung Surfactant
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Tue, 14 Aug 2007, 18:49:58 EST