Comparison of icodextrin and glucose solutions for long-dwell exchange in continuous ambulatory peritoneal
dialysis patients; a preliminary study
Fatemeh Yaghoubi
1, Sudabeh Alatab
2*, Iraj Najafi
11 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
Abstract
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.