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NDT Advance Access originally published online on October 12, 2005
Nephrology Dialysis Transplantation 2006 21(2):494-498; doi:10.1093/ndt/gfi197
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Original Articles: Dialysis and Transplantation

Beneficial effects of icodextrin on plasma level of adipocytokines in peritoneal dialysis patients

Ryuichi Furuya1, Mari Odamaki2, Hiromichi Kumagai2 and Akira Hishida3

1 Department of Internal Medicine, Iwata City Hospital, Iwata, Japan, 2 Department of Clinical Nutrition, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan and 3 First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

Correspondence and offprint requests to: Ryuichi Furuya, MD, PhD, Renal Division, Department of Internal Medicine, Iwata City Hospital, 512-3 Ohkubo, Iwata, 438-8550, Japan. Email: r-furuya{at}isis.ocn.ne.jp

Objective. Leptin and adiponectin, well-recognized adipocytokines, are reported to contribute to the pathogenesis of atherosclerosis. The aim of this study was to elucidate the effects of icodextrin-based dialysis solution on adipocytokine metabolism.

Methods. In 12 non-diabetic anuric patients on peritoneal dialysis, dialysis solution was changed from glucose-based dialysis solution to icodextrin-based dialysis solution for 6 months. Plasma levels of leptin, adiponectin, lipids (total cholesterol, HDL-cholesterol and triglyceride), insulin, blood glucose and insulin sensitivity index by the homeostasis model assessment (HOMA-IR) were compared before and after the use of the icodextrin solution.

Results. Plasma leptin level was decreased from 15.6 (2.5–69.0) to 7.3 (2.9–45.9) ng/ml (P = 0.018) and plasma adiponectin level increased from 11.6 (6.2–19.6) to 17.6 (7.8–33.0) µg/ml (P = 0.002). A reduction in plasma insulin level from 33.1 (13.8–54.1) to 19.1 (5.8–37.3) µU/ml (P = 0.009) and HOMA-IR from 8.22 (3.68–15.09) to 5.15 (1.40–13.78) (P = 0.015) was observed. While plasma total cholesterol level remained similar, HDL-cholesterol level increased, from 36.0 (22–45) to 43.5 (30–69) mg/dl (P = 0.008) and the triglyceride level decreased, from 174.0 (140–250) to 116.5 (81–207) mg/dl (P = 0.012).

Conclusion. Icodextrin-based dialysis solution improves abnormal adipocytokine metabolism, dyslipidaemia and insulin resistance, which are known to be associated with atherosclerosis. These results suggest that the use of icodextrin-based dialysis solution might be useful in preventing atherosclerosis in PD patients. Long-term effects of icodextrin-based dialysis solution on the atherosclerosis in peritoneal dialysis patients should be tested.

Keywords: adiponectin; dyslipidaemia; icodextrin; insulin resistance; leptin; peritoneal dialysis


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