Peritoneal Reaction to Icodextrin in a Female Patient on CAPD

Heering, Peter; Brause, M.; Plum, J; Grabensee, B

doi:10.1177/089686080102100320

Cited by 24 publications

(21 citation statements)

References 2 publications

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“…The starting point of this rash (peritoneal catheter exit site), the negative skin test results (when read immediately or later), suggest an immune process that begins in the peritoneum This hypothesis is compatible with the observation of Heering et al. who demonstrated that icodextrin could induce pseuperitonitis and lymphocyte stimulation (9). The maculopapular skin rash could be a distant manifestation of the peritoneal immune process.…”

supporting

confidence: 83%

Hypersensitivity to icodextrin

Kanny¹,

Durand²,

Beaudouin³

et al. 2002

Allergy

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supporting

confidence: 83%

Hypersensitivity to icodextrin

Kanny¹,

Durand²,

Beaudouin³

et al. 2002

Allergy

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“…Episodes of sterile peritonitis have also been reported that were caused by endotoxin contamination of the dialysis solution, intraperitoneal chemical agents (including glucose degradation products and several drugs), allergic mechanisms (including eosinophilic peritonitis) or, rarely, by peritoneal metastases, pancreatitis and abdominal lymphomas [ 29–34 ]. Between November 2001 and July 2002, a markedly increased incidence of sterile peritonitis associated with icodextrin treatment was reported [ 35–41 ]. These cases were caused by a peptidoglycan (released from Alicyclobacillus acidocaldarius, a thermophilic acidophilic Gram-positive organism contaminating the cornstarch used for icodextrin production) [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Icodextrin does not impact infectious and culture-negative peritonitis rates in peritoneal dialysis patients: a 2-year multicentre, comparative, prospective cohort study

Vychytil

Remón

Michel

et al. 2008

Nephrology Dialysis Transplantation

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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 (Extraneal™) 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.

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“…Other authors have suggested that sterile peritonitis in patients on icodextrin might be allergic reactions similar to skin lesions (4,5).…”

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confidence: 99%