Determinants of low clearances of small solutes during peritoneal dialysis

Peritoneal dialysis plasma clearances of large molecular weight solutes such as inulin (5,200 daltons) usually equal or exceed plasma clearances of such solutes seen with extracorporeal dialyzers, [1–4]. Clearances of smaller solutes such as urea (60 daltons), however, are usually 15% or less of urea clearances with extracorporeal dialysis systems. In Table 1, typical values for clearances of urea and inulin, dialysis solution flow rate (QD), blood flow rate (QB), and surface area are compared for peritoneal and extracorporeal (hemodialysis) techniques. Effective peritoneal capillary blood flow rate is unknown. Gross total anatomical peritoneal surface area is estimated to be approximately equal to body surface area [2, 4]

Incentives for organ donation: proposed standards for an internationally acceptable system.

Incentives for organ donation, currently prohibited in most countries, may increase donation and save lives. Discussion of incentives has focused on two areas: (1) whether or not there are ethical principles that justify the current prohibition and (2) whether incentives would do more good than harm. We herein address the second concern and propose for discussion standards and guidelines for an acceptable system of incentives for donation. We believe that if systems based on these guidelines were developed, harms would be no greater than those to today's conventional donors. Ultimately, until there are trials of incentives, the question of benefits and harms cannot be satisfactorily answered