Neostigmine Increases Net Ultrafiltration and Solute Clearances in Peritoneal Dialysis by Reducing Lymphatic Absorption

Peritoneal cavity lymphatic absorption significantly reduces net ultrafiltration (UF) and solute clearances in peritoneal dialysis.(1,2) Lymphatic absorption from the peritoneal cavity occurs primarily via the subdiaphragmatic stomata(3) which constrict following intraperitoneal administration of cholinergic drugs.(4) Neostigmine, an anticholinesterase agent, is also thought to reduce the patency of the subdiaphragmatic stomata and so may reduce lymphatic drainage of intraperitoneal fluid. This study was performed to evaluate net UF, solute clearances, and lymphatic absorption during single hypertonic exchanges in rats using 2.5% dextrose dialysis solution with and without added neostigmine.