Distributed model of peritoneal transport: implications of the endothelial glycocalyx.

This commentary discusses the conceptual and mathematical modelling of solute and water transport across the peritoneum and attempts to put a ‘new’ physiologic entity, the endothelial glycocalyx, into perspective. In the clinic, concepts analogous to the membrane barrier in haemodialysis are used to form simplified mathematical schemes to provide rapid estimation of the transport. In contrast, fundamental research on the pathophysiology of the peritoneal barrier demands models that include important elements of the anatomy that have been demonstrated to influence solute and water transport. If potentially critical elements in the barrier, such as the cell-interstitial matrix, are neglected, their importance will never be realized. In this brief article, the potential importance of the endothelial glycocalyx to our understanding of the pathophysiologic changes in the peritoneum is explored.