Nephrology Dialysis Transplantation, Vol 12, Issue 3 550-553, Copyright © 1997 by Oxford University Press
N Posthuma, PM ter Wee, HA Verbrugh, PL Oe, E Peers, J Sayers and AJ Donker
BACKGROUND AND METHODS: Icodextrin 7.5% is an iso-osmolar, glucose
polymer-containing peritoneal dialysis solution with an ultrafiltration
potential similar to glucose 3.86%. We compared in an open, randomized,
prospective study the ultrafiltration potential of icodextrin with that of
glucose during the daytime dwell of 23 patients treated with automated
peritoneal dialysis (CCPD). RESULTS: Daytime ultrafiltration volume and
24-h ultrafiltration volume increased significantly in icodextrin-treated
patients (n = 11) at 3 and 6 months, allowing patients a less rigid fluid
restriction or an adapted treatment schedule. This improved the patients'
subjective well-being. Although ultrafiltration at 9 and 12 months also
increased it did not reach statistical significance. Similar to the gain in
ultrafiltration volume, 24-h dialysate creatinine clearance per 1.73 m2
(DCl/1.73 m2) and DCl/1.73 m2 per litre used dialysate (DCl/1.73 m2/l)
increased in icodextrin-treated patients. DCl/1.73 m2/l per litre
ultrafiltrate (DCl/1.73 m2/l/UF) did not increase. No side-effects of
icodextrin were encountered, although serum disaccharide levels increased.
CONCLUSION: Icodextrin enhances ultrafiltration during the daytime dwell in
CCPD patients. As a result of an increased 24-h ultrafiltration volume,
DCl/1.73 m2 and DCl/1.73 m2/l improve. DCl/1.73 m2/l/UF does not rise,
which suggests that the increase in DCl/1.73 m2 and DCl/1.73 m2/l is caused
by convective transport.
ORIGINAL ARTICLES
Icodextrin instead of glucose during the daytime dwell in CCPD increases ultrafiltration and 24-h dialysate creatinine clearance
Department of Nephrology, Free University Hospital Amsterdam, The Netherlands.
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