Icodextrin use in CCPD patients during peritonitis: ultrafiltration and serum disaccharide concentrations

Posthuma, N.; Weel, P. M. Ter; Donker, A. J. M.; Peers, Elizabeth; Oe, P. L.; Verbrugh, Henri A.

doi:10.1093/ndt/13.9.2341

Cited by 51 publications

(27 citation statements)

References 1 publication

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“…It is becoming increasingly clear that one of the primary responsibilities of clinicians in the management of PD patients is the balance between adequate control of fluid status and preservation of residual renal function. Numerous clinical studies (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(35)(36)(37) and more than 9 years of post-marketing surveillance have confirmed that icodextrin is a safe and well-tolerated osmotic alternative PD solution to glucose. The most significant adverse effect reported to date is a cutaneous hypersensitivity reaction (38,39).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Icodextrin and Glucose Solutions for Long Dwell Exchange in Peritoneal Dialysis: A Meta-Analysis of Randomized Controlled Trials

et al. 2011

Perit Dial Int

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♦ Background: Icodextrin is widely used in peritoneal dialysis (PD); however, the safety and efficacy of icodextrin are unclear. In the present study, we performed a systematic review of randomized controlled trials (RCTs) that compared icodextrin and glucose for the once-daily long dwell in PD. ♦ Methods: Electronic searches were performed in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to select all eligible studies. Eligible studies, as determined by consensus using predefined criteria, were reviewed, and data were extracted onto a standard form. ♦ Results: In the 9 RCTs that were identified, patients using icodextrin were found to have much greater net ultrafiltration (UF) and a lower incidence of negative net UF compared to patients using 1.5%, 2.5%, and 4.25% glucose solutions. Additionally, icodextrin has a markedly increased UF efficiency ratio and peritoneal clearance of creatinine and urea nitrogen, but residual renal function was not different from patients using glucose solutions for PD. No significant differences were observed between icodextrin and glucose groups with respect to risk of mortality, peritonitis, and total adverse events. Although rashes occurred significantly more often in icodextrin groups, few differences were noted between icodextrin and glucose groups when withdrawal rates secondary to adverse events were compared. ♦ Conclusions: This meta-analysis suggests that icodextrin provides patients with greater fluid removal and small solute clearance and does not cause any damage to residual renal function. Icodextrin is particularly appropriate for use in patients with high peritoneal transport status.

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Section: Discussionmentioning

confidence: 99%

Comparison of Icodextrin and Glucose Solutions for Long Dwell Exchange in Peritoneal Dialysis: A Meta-Analysis of Randomized Controlled Trials

et al. 2011

Perit Dial Int

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“…However, the beneficial effect of icodextrin on the glycemic control has not been confirmed in all studies [19]. Icodextrin preserves or even increases UF capacity during peritonitis, in contrast to glucose [20,21].…”

Section: Discussionmentioning

confidence: 99%

Two icodextrin exchanges per day in peritoneal dialysis patients with ultrafiltration failure: one center’s experience and review of the literature

et al. 2010

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“…In addition a reduced size selectivity is present in the early phase [5], leading to a decrease in the peritoneal restriction coefficient to macromolecules [24]. The presence of an increased effective peritoneal surface area leads to lower ultrafiltration rates on glucose-based solutions [22] and higher ultrafiltration rates on an icodextrin-based fluid [25,26]. These functional alterations are temporary and disappear after cure from the infection [22].…”

Section: Peritoneal Transport and Inflammatory Mediators During Peritmentioning

confidence: 99%

Peritoneal Membrane Failure in Peritoneal Dialysis Patients

et al. 2002

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A review is given of the conditions associated with peritoneal membrane failure, and the possible causes. Ultrafiltration failure is the most important manifestation. It is mostly associated with high transport rates of low molecular weight solutes suggesting the presence of a large vascular surface area. Enlargement of the peritoneal surface area can be functional (effective surface area: more perfused microvessels) or anatomic (more microvessels). The former is likely to be present in some patients in the beginning of peritoneal dialysis, and also during peritonitis. The latter can develop in long-term peritoneal dialysis.

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Icodextrin use in CCPD patients during peritonitis: ultrafiltration and serum disaccharide concentrations

Abstract: 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.

Cited by 51 publications

References 1 publication

Comparison of Icodextrin and Glucose Solutions for Long Dwell Exchange in Peritoneal Dialysis: A Meta-Analysis of Randomized Controlled Trials

Comparison of Icodextrin and Glucose Solutions for Long Dwell Exchange in Peritoneal Dialysis: A Meta-Analysis of Randomized Controlled Trials

Two icodextrin exchanges per day in peritoneal dialysis patients with ultrafiltration failure: one center’s experience and review of the literature

Peritoneal Membrane Failure in Peritoneal Dialysis Patients

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