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The challenge of research patient recruitment is intensifying in the 1990s. Relevant factors include the often negative impact of the press, increasing competition for patients, an increasingly ethnically diverse population, and a pervasive trend toward managed care. Based on preliminary findings from a patient focus group, 550 patients were contacted by mail and asked to complete a 25-item questionnaire. Survey results indicate that for most study patients initial telephone contact with a health care professional is not as important as the perception of a genuinely caring (i.e., "non-guinea pig") environment. Office location and other intangibles also affect recruitment; furthermore, several of the benefits sought by volunteers transcend ethnicity. The trend toward managed care will not impede and may enhance research patient recruitment. This research provides information and data that will enable investigators and sponsors to better meet the challenges of patient recruitment in the 1990s.

Peritoneal transfer kinetics of substances differing in molecular size and lipophilic properties were studied in anuric adult rabbits with ligated ureters. In conscious animals, the dialysate/plasma concentration ratios of creatinine (Cr) and inulin (In) rose exponentially up to 200 min of dwelling. Peritoneal CIn was 0.24 ml/min/kg, and CCr was 0.10 ml/min/kg of body wt. The transfer rate for dipropyl acetic acid (VPA) was higher than for its more lipophilic analogue dibutyl acetic acid (DBA); the apparent equilibrium of the dialysate/plasma concentration ratio for VPA was 0.3 to 0.6 and 0.15 to 0.20 for DBA. Correspondingly, the peritoneal CVPA was higher (0.08 to 0.16 ml/min/kg) than CDBA (0.04 to 0.05 ml/min/kg); peritoneal clearances were 8% vs. 1.5% of the plasma clearances. The addition of nitroglycerin, dopamine, isoprenalin, fenoterol, and nitroprusside sodium to the dialysate did not increase significantly the peritoneal CCr and CIn during 30-min cycles. In conclusion, the peritoneal transport kinetics of creatinine, inulin, and protein are qualitatively similar to clinical data, but of different magnitude. The efficiency of peritoneal dialysis depends on the lipophilic characteristics of the substance to be transferred. The vasoactive drugs studied seem not to be promising for increasing the efficiency of peritoneal transport.