ABSTRACT
Irreversible end-stage kidney disease occurs with an annual frequency of about 1 in 5,000 to 10,000 in general population, and this rate is increasing. Until the 1960s, such disease was universally fatal. In the last four decades various interventions have been developed and implemented for preserving life after loss of all or most of a patient’s own kidney function. Continuous ambulatory peritoneal dialysis (CAPD), the newest and most rapidly growing of renal replacement therapies, is one such process in which metabolic waste products, electrolytes, and water are removed through the peritoneum, an intricate membrane like tissue that lines the abdominal cavity and covers the liver, intestine, and other internal organs. This review begins with a brief summary of the development of CAPD and its role in the treatment of contemporary renal failure. The therapy format and its capacity for solute removal are then described in detail. Bioengineering studies of peritoneal transport, in which the peritoneum is described in terms analogous to the mass transfer properties of a planar membrane separating well-mixed pools of blood and dialysate, are then reviewed. The transport properties of the equivalent peritoneal membrane are summarized and compared to those of hemodialysis membranes. Mode’s to describe and predict fluid and solute removal rates are examined. Finally, current developments and emerging trends are summarized.
