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Icodextrin produces higher ultrafiltration in diabetic than in non-diabetic patients on continuous cyclic peritoneal dialysis

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A preliminary report from our unit previously suggested that diabetic patients on continuous cyclic peritoneal dialysis (CCPD) have higher ultrafiltration (UF) with icodextrin than non-diabetic patients. To confirm this observation, we did a retrospective analysis of our patients (17 diabetic and 23 non-diabetic) who were on stable CCPD prescription using a long-day dwell with icodextrin. We collected daily UF data from these patients’ records for 30 days. The two groups showed no significant difference with respect to age, gender, hemoglobin, serum albumin, peritoneal dialysis and icodextrin vintage, peritoneal membrane characteristics, CCPD prescription, and peritoneal and residual renal clearance. The overnight net UF achieved with the cycler with standard glucose dialysate was similar in the two groups (850 ± 379 in diabetic vs 713 ± 484 ml/day in non-diabetic, P = 0.34). However, UF with icodextrin during the day dwell (14.8 ± 0.8 h) was significantly higher in diabetics than non-diabetics (348 ± 198 vs 137 ± 311 ml/day, P = 0.02). Our results show that icodextrin produces significantly higher UF in long-day dwell in diabetic ESRD patients on CCPD than in non-diabetic patients. The reason for this difference is not clear.

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  1. 1.

    Chung SH, Stenvinkel P, Bergstrom J, Lindholm B (2000) Biocompatibility of new peritoneal dialysis solutions: what can we hope to achieve? Perit Dial Int 20(Suppl 5):S57–S67

  2. 2.

    Wolfson M, Piraino B, Hamburger RJ, Morton AR, Icodextrin Study Group (2002) A randomized controlled trial to evaluate the efficacy and safety of icodextrin in peritoneal dialysis. Am J Kidney Dis 40(5):1055–1065

  3. 3.

    Mistry CD, Gokal R, Peers E (1994) A randomized multicenter clinical trial comparing isosmolar icodextrin with hyperosmolar glucose solutions in CAPD. MIDAS Study Group. Multicenter Investigation of Icodextrin in Ambulatory Peritoneal Dialysis. Kidney Int 46(2):496–503

  4. 4.

    Martikainen T, Ekstrand A, Honkanen E, Teppo AM, Gronhagen-Riska C (2005) Do interleukin-6, hyaluronan, soluble intercellular adhesion molecule-1 and cancer antigen 125 in dialysate predict changes in peritoneal function? Scand J Urol Nephrol 39(5):410–416

  5. 5.

    Marshall J, Jennings P, Scott A, Fluck RJ, McIntyre CW (2003) Glycemic control in diabetic CAPD patients assessed by continuous glucose monitoring system (CGMS). Kidney Int 64:1480–1486

  6. 6.

    Woodrow G, Oldroyd B, Stables G, Gibson J, Turney JH, Brownjohn AM (2000) Effects of icodextrin in automated peritoneal dialysis on blood pressure and biolelectrical impedance analysis. Nephrol Dial Transplant 15:862–866

  7. 7.

    Van V, Schoonjans RS, Struijk DG, Verbanck JJ, Vanholder RC, Van B, Lefebvre RA, De V, Lameire NH (2002) Influence of dialysate on gastric emptying time in peritoneal dialysis patients. Perit Dial Int 22:32–38

  8. 8.

    Davies SJ, Woodrow G, Donovan K, Plum J, Williams P, Johansson AC, Bosselmann HP, Heimburger O, Simonsen O, Davenport A, Tranaeus A, Divino Filho JC (2003) Icodextrin improves the fluid status of peritoneal dialysis patients: results of a double blind randomized controlled trial. J Am Soc Nephrol 14(9):2338–2344

  9. 9.

    Jeloka TK, Oreopoulos DG (2006) Is ultrafiltration with icodextrin higher in diabetics than in non-diabetics? Perit Dial Int 26(6):729–730

  10. 10.

    Twardowski ZJ, Nolph KD, Khanna R et al (1987) Peritoneal equilibration test. Perit Dial Bull 7:138–147

  11. 11.

    Finkelstein F, Healy H, Abu-Alfa A, Ahmad S, Brown F, Gehr T, Nash K, Sorkin M, Mujais S (2005) Superiority of icodextrin compared with 4.25% dextrose for peritoneal ultrafiltration. J Am Soc Nephrol 16(2):546–554

  12. 12.

    Willie ME, Plant MJ, Edwards L, Brown CB (1997) Icodextrin 7.5% dialysate solution (glucose polymer) in patients with ultrafiltration failure: extension of CAPD technique survival. Perit Dial Int 17(1):84–87

  13. 13.

    Imholz AL, Brown CB, Koomen GC, Arisz L, Krediet RT (1993) The effect of glucose polymers on water removal and protein clearances during CAPD. Adv Perit Dial 9:25–30

  14. 14.

    Wiggins KJ, Rumpsfeld M, Blizzard S, Johnson DW (2005) Predictors of a favourable response to icodextrin in peritoneal dialysis patients with ultrafiltration failure. Nephrology (Carlton) 10:33–36

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Correspondence to Mufazzal Ahmad.

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Ahmad, M., Jeloka, T., Pliakogiannis, T. et al. Icodextrin produces higher ultrafiltration in diabetic than in non-diabetic patients on continuous cyclic peritoneal dialysis. Int Urol Nephrol 40, 219–223 (2008). https://doi.org/10.1007/s11255-007-9298-3

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  • Diabetes mellitus
  • Icodextrin
  • Peritoneal dialysis
  • Ultrafiltration