NDT Advance Access first published online on June 13, 2008
This version published online on June 18, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn322
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Icodextrin does not impact infectious and culture-negative peritonitis rates in peritoneal dialysis patients: a 2-year multicentre, comparative, prospective cohort study
1 Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Austria 2 Division of Nephrology, Hospital Puerto Real, Cadiz, Spain 3 Division of Nephrology, Hôpital Bichat, Paris, France 4 Division of Nephrology, The Ipswich Hospital, Ipswich, UK 5 Division of Nephrology, Hospital Juan Canalejo, Coruna, Spain 6 Baxter Healthcare, Brussels, Belgium
Correspondence and offprint requests to: Andreas Vychytil, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Tel: +43-1-40400-4495; Fax: +43-1-40400-4499; E-mail: andreas.vychytil{at}meduniwien.ac.at
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Abstract |
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Background. Icodextrin is a glucose polymer derived by hydrolysis of cornstarch. The different biocompatibility profile of icodextrin-containing peritoneal dialysis (PD) solutions may have a positive influence on peritoneal host defence. Furthermore, cases of sterile peritonitis potentially associated with icodextrin have been reported.
Methods. The primary objective of this multicentre, longitudinal, observational, non-interventional, prospective cohort study, which included 722 PD patients, was to evaluate the incidence of overall peritonitis in patients treated with icodextrin-containing PD solutions (ExtranealTM) used during one long-dwell exchange/day compared with those treated with non-icodextrin-containing PD solutions. The secondary objective was to determine if culture-negative peritonitis rates differed between patients treated with icodextrin from two independent manufacturers. All peritonitis episodes were assessed by a Steering Committee in a blind manner.
Results. There was no significant difference between icodextrin-treated and control patients in the adjusted overall, culture-positive or culture-negative peritonitis rates. When stratified by the icodextrin supplier, there was no significant difference in the adjusted rate of culture-negative peritonitis episodes between groups.
Conclusion. Subjects receiving icodextrin as part of their PD regimen experienced neither a higher rate of culture-negative peritonitis nor a lower rate of infectious peritonitis compared with non-icodextrin users. There was no significant influence of the icodextrin raw material supplier on peritonitis rates.
Keywords: biocompatibility; glucose degradation products; glucose polymer; peptidoglycan; sterile peritonitis
* Sites and members of the Extraneal Peritonitis Study Group are listed in the Appendix.
The original version of this paper was incorrect. An author name in the Appendix was incorrectly displayed.
Received for publication: 28.12.07
Accepted in revised form: 19. 5.08