Abstract
Introduction: Icodextrin is widely used in peritoneal dialysis (PD) and several clinical observations suggest the superiority of icodextrin compared with 4.25% dextrose in optimizing peritoneal ultrafiltration (UF). However this solution has been introduced to our PD centers over the last two years. Objectives: In this study we aimed to evaluate the effects of employment of this solution in our PD patients. Patients and Methods: The study was carried out in two Iranian PD centers (Shafa and Shariati centers). We included 29 established patients (12 male and 17 female, mean age 58.9 ±11.1 years) who used icodextrin for the long-dwell exchange for last 6 months. Clinical data were collected at baseline and 6 months after icodextrin administration. Results: When the data between baseline and after 6 months of icodextrin administration was evaluated, we found no significant change in evaluated parameters including 24 hours UF, 24 hours urine volume, membrane transport type, Kt/V and creatinine clearance was observed. Conclusion: Icodextrin for the long-dwell exchange did not improve the creatinine clearance despite producing, a non-significant increase in 24-hour UF, after 6 months. Due to low proportion of patients and high inter-patients variability we cannot reach a robust conclusion. Studies with bigger sample size involving several PD centers are necessary to further address this subject.
Highlights
Icodextrin is widely used in peritoneal dialysis (PD) and several clinical observations suggest the superiority of icodextrin compared with 4.25% dextrose in optimizing peritoneal ultrafiltration (UF)
When the data between baseline and after 6 months of icodextrin administration was evaluated, we found that mean arterial blood pressure significantly decreased after icodextrin treatment (105.3 mm Hg vs 93.5 mm Hg), no significant change in the other evaluated parameters was observed
Several studies showed the benefits of icodextrin such as: attenuation of total glucose load, achieving higher UF than that obtained by hypertonic glucose solution, and better control of fluid balance and the overall message of these studies is that icodextrin is superior in creatinine clearance (CrCl) and UF to solutions containing high glucose concentration [13,17,18,19]
Summary
Icodextrin is widely used in peritoneal dialysis (PD) and several clinical observations suggest the superiority of icodextrin compared with 4.25% dextrose in optimizing peritoneal ultrafiltration (UF) This solution has been introduced to our PD centers over the last two years. The incidence of ESRD starts to decrease in developed countries in recent years, which probably caused by increased awareness of CKD (at least partly) No such change is seen in developing countries or minority populations [1]. Continuous ambulatory peritoneal dialysis (CAPD) is one of the kidney replacement therapy that has been applied worldwide for more than 25 years in ESRD patients [2]. In some countries such as Hong Kong and Singapore
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