Nephrology Dialysis Transplantation, Vol 13, Issue 9 2341-2344, Copyright © 1998 by Oxford University Press
N Posthuma, P ter Weel, A Donker, E Peers, P Oe and H Verbrugh
Background and methods: In a randomized study on the
biocompatibility of icodextrin (I) versus glucose (G) in CCPD we used
icodextrin or glucose for the long daytime dwell. During the night-time
dwells glucose was used in all patients. In case of peritonitis icodextrin
was continued. In all patients ultrafiltration (UF) was recorded and serum
icodextrin metabolites were determined every 3 months and during
peritonitis in I-users when available. Results:
Thirty-eight patients (19 G, 19 I) entered the study and suffered 30
peritonitis episodes (16 G, 14 I). During peritonitis (P), daytime dwell UF
decreased significantly in G (P=0.001), but remained stable in I patients
compared to non-peritonitis (NP) episodes. Total 24-h UF decreased in G
(P=0.001) and in I patients (P=0.04), as the result of a decreased daytime
UF and night-time UF, respectively. There was no difference in the used
glucose concentrations during the P versus NP episodes. In five I-patients
serum disaccharides increased from 0.05±0.01 to
1.26±0.23 mg/ml during follow up. During peritonitis serum
disaccharide concentrations did not increase further (1.47±0.24
mg/ml, P=0.56). In I patients total carbohydrate minus glucose rose to
5.72±1.2 mg/ml during follow up, and to 6.63±1.04
mg/ml during peritonitis (P=0.7). These concentrations are comparable to
CAPD patients despite the longer dwelltime in CCPD (8-10 versus 14-16 h,
respectively). Adverse reactions attributable to icodextrin were not
encountered. Conclusions: In contrast to glucose,
icodextrin preserved the daytime dwell ultrafiltration during peritonitis.
Serum icodextrin metabolites increased during icodextrin use, but remained
stable during peritonitis. Adverse effects were not observed. Key
words: disaccharides; icodextrin; maltose; peritoneal dialysis;
peritonitis; ultrafiltration
PRELIMINARY REPORTS
Icodextrin use in CCPD patients during peritonitis: ultrafiltration and serum disaccharide concentrations
Departments of Nephrology and Internal Medicine, Academisch Ziekenhuis Vrije Universiteit, Postbus 7057, 1007 MB Amsterdam, The Netherlands; Department of Microbiology, University Hospital of Rotterdam, The Netherlands; ML Laboratories plc, Blaby, UK; Corresponding author
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