Submitted: 07 Mar 2018
Accepted: 10 Oct 2018
First published online: 05 Nov 2018
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J Renal Inj Prev. 2019;8(2):65-70.
doi: 10.15171/jrip.2019.13
  Abstract View: 50
  PDF Download: 45

Original Article

Comparison of icodextrin and glucose solutions for longdwell exchange in continuous ambulatory peritoneal dialysis patients; a preliminary study

Fatemeh Yaghoubi 1, Sudabeh Alatab 2 * , Iraj Najafi 1

1 Nephrology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
*Corresponding author: Sudabeh Alatab, MD, PhD, Email: Email: sudabehalatab@yahoo.com

Article

Introduction: Icodextrin is widely used in peritoneal dialysis (PD) and several clinical observations suggest the superiority of icodextrin compared with 4.25% dextrose in optimizing peritoneal ultrafiltration (UF). However this solution has been introduced to our PD centers over the last two years. Objectives: In this study we aimed to evaluate the effects of employment of this solution in our PD patients. Patients and Methods: The study was carried out in two Iranian PD centers (Shafa and Shariati centers). We included 29 established patients (12 male and 17 female, mean age 58.9 ±11.1 years) who used icodextrin for the long-dwell exchange for last 6 months. Clinical data were collected at baseline and 6 months after icodextrin administration. Results: When the data between baseline and after 6 months of icodextrin administration was evaluated, we found no significant change in evaluated parameters including 24 hours UF, 24 hours urine volume, membrane transport type, Kt/V and creatinine clearance was observed. Conclusion: Icodextrin for the long-dwell exchange did not improve the creatinine clearance despite producing, a non-significant increase in 24-hour UF, after 6 months. Due to low proportion of patients and high inter-patients variability we cannot reach a robust conclusion. Studies with bigger sample size involving several PD centers are necessary to further address this subject.

Implication for health policy/practice/research/medical education:

In recent years, more biocompatible peritoneal dialysis (PD) solutions such as icodextrin are being developed to produce sustained positive net ultrafiltration over long dwells while reducing the glucose load and therefore causing potentially less damage to peritoneal cells compared to solutions containing 4.25% dextrose. In our country, it is not a long-time that icodextrin has been introduced to our PD patients. Our data concerning the inability of icodextrin to improve the creatinine clearance should be interpreted with caution as our sample size was small. This study could be an initiation for performing other studies with larger sample size to justify the use of this solution in our country.

Please cite this paper as: Yaghoubi F, Alatab S, Najafi I. Comparison of icodextrin and glucose solutions for long-dwell exchange in continuous ambulatory peritoneal dialysis patients; a preliminary study. J Renal Inj Prev. 2019;8(2):65-70. DOI: 10.15171/jrip.2019.13.

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