Skip to main content
SpringerLink
Log in

Factors related to ultrafiltration volume with icodextrin dialysate use in children

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

Icodextrin has a lower absorption rate, and icodextrin peritoneal dialysate contributes to more water removal than glucose dialysate in patients with high peritoneal permeability. There are limited data on icodextrin dialysate use in children.

Methods

This study included all pediatric patients who received peritoneal equilibration tests and peritoneal dialysis with icodextrin dialysate at the study center. The factors related to ultrafiltration volume with icodextrin dialysate with long dwell time were statistically analyzed. Then the ultrafiltration volume with icodextrin and medium-concentration glucose dialysate was compared in individual cycles in the same patients.

Results

Thirty-six samples were included in the icodextrin group, and nine samples were used to compare the ultrafiltration volume with icodextrin and glucose dialysate. Dwell time, D/P-creatinine, D/D0-glucose, age, height, and weight correlated significantly with the ultrafiltration volume of icodextrin dialysate (p < 0.05). A dwell volume equal to or more than 550 mL/m2 was associated with a significantly higher ultrafiltration volume than a lower dwell volume (p = 0.039). Multiple regression analysis revealed that dwell time (p = 0.038) and height (p < 0.01) correlated with ultrafiltration volume significantly. In addition, the ultrafiltration volume was superior (p < 0.01), and dwell time was longer (p = 0.02), with icodextrin dialysate than with medium-concentration glucose dialysate.

Conclusions

The ultrafiltration volume with icodextrin dialysate decreases in patients with small stature. Providing sufficient dwell time and volume is important for maximal water removal even in children. Ultrafiltration volume is superior with icodextrin than medium-concentration glucose dialysate for long dwell times.

Graphical abstract

A higher resolution version of the Graphical abstract is available as Supplementary information

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

This retrospective study was based on data obtained from electronic medical records at the study center.

Code availability

IBM SPSS statistics was licensed by the study center.

References

  1. Twardowski ZJ, Khanna R, Nolph KD (1986) Osmotic agents and ultrafiltration in peritoneal dialysis. Nephron 42:93–101. https://doi.org/10.1159/000183645

    Article  CAS  PubMed  Google Scholar 

  2. Peers E, Gokal R (1997) Icodextrin: overview of clinical experience. Perit Dial Int 17:22–26

    Article  CAS  PubMed  Google Scholar 

  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 46:496–503. https://doi.org/10.1038/ki.1994.300

    Article  CAS  PubMed  Google Scholar 

  4. Pannekeet MM, Imholz AL, Struijk DG, Koomen GC, Langedijk MJ, Schouten N, de Waart R, Hiralall J, Krediet RT (1995) The standard peritoneal permeability analysis: a tool for the assessment of peritoneal permeability characteristics in CAPD patients. Kidney Int 48:866–875. https://doi.org/10.1038/ki.1995.363

    Article  CAS  PubMed  Google Scholar 

  5. Olszowska A, Waniewski J, Stachowska-Pietka J, Garcia-Lopez E, Lindholm B, Wańkowicz Z (2019) Long peritoneal dialysis dwells with icodextrin: Kinetics of transperitoneal fluid and polyglucose transport. Front Physiol 10:1326. https://doi.org/10.3389/fphys.2019.01326

    Article  PubMed  PubMed Central  Google Scholar 

  6. Posthuma N, ter Wee PM, Verbrugh HA, Oe PL, Peers E, Sayers J, Donker AJ (1997) Icodextrin instead of glucose during the daytime dwell in CCPD increases ultrafiltration and 24-h dialysate creatinine clearance. Nephrol Dial Transplant 12:550–553. https://doi.org/10.1093/ndt/12.3.550

    Article  CAS  PubMed  Google Scholar 

  7. de Boer AW, Schröder CH, van Vliet R, Willems JL, Monnens LA (2000) Clinical experience with icodextrin in children: ultrafiltration profiles and metabolism. Pediatr Nephrol 15:21–24. https://doi.org/10.1007/s004670000406

    Article  PubMed  Google Scholar 

  8. Rousso S, Banh TM, Ackerman S, Piva E, Licht C, Harvey EA (2016) Impact of fill volume on ultrafiltration with icodextrin in children on chronic peritoneal dialysis. Pediatr Nephrol 31:1673–1679. https://doi.org/10.1007/s00467-016-3398-1

    Article  PubMed  Google Scholar 

  9. Paniagua R, Ventura MD, Avila-Díaz M, Hinojosa-Heredia H, Méndez-Durán A, Cueto-Manzano A, Cisneros A, Ramos A, Madonia-Juseino C, Belio-Caro F, García-Contreras F, Trinidad-Ramos P, Vázquez R, Ilabaca B, Alcántara G, Amato D (2010) NT-proBNP, fluid volume overload and dialysis modality are independent predictors of mortality in ESRD patients. Nephrol Dial Transplant 25:551–557. https://doi.org/10.1093/ndt/gfp395

    Article  CAS  PubMed  Google Scholar 

  10. Geary DF, Harvey EA, MacMillan JH, Goodman Y, Scott M, Balfe JW (1992) The peritoneal equilibration test in children. Kidney Int 42:102–105. https://doi.org/10.1038/ki.1992.267

    Article  CAS  PubMed  Google Scholar 

  11. Fischbach M, Zaloszyc A, Schaefer B, Schmitt CP (2017) Should sodium removal in peritoneal dialysis be estimated from the ultrafiltration volume? Pediatr Nephrol 32:419–424. https://doi.org/10.1007/s00467-016-3378-5

    Article  PubMed  Google Scholar 

  12. Fischbach M, Terzic J, Menouer S, Haraldsson B (2000) Optimal volume prescription for children on peritoneal dialysis. Perit Dial Int 20:603–606

    Article  CAS  PubMed  Google Scholar 

  13. de Boer AW, van Schaijk TC, Willems HL, de Haan AF, Monnens LA, Schröder CH (1997) Follow-up study of peritoneal fluid kinetics in infants and children on peritoneal dialysis. Perit Dial Int 19:572–577

    Article  Google Scholar 

  14. Dart A, Feber J, Wong H, Filler G (2005) Icodextrin re-absorption varies with age in children on automated peritoneal dialysis. Pediatr Nephrol 20:683–685. https://doi.org/10.1007/s00467-004-1783-7

    Article  PubMed  Google Scholar 

  15. Smit W, Parikova A, Struijk DG, Krediet RT (2005) The difference in causes of early and late ultrafiltration failure in peritoneal dialysis. Perit Dial Int 25(Suppl 3):S41–S45

    Article  PubMed  Google Scholar 

  16. Ha IS, Yap HK, Munarriz RL, Zambrano PH, Flynn JT, Bilge I, Szczepanska M, Lai WM, Antonio ZL, Gulati A, Hooman N, van Hoeck K, Higuita LM, Verrina E, Klaus G, Fischbach M, Riyami MA, Sahpazova E, Sander A, Warady BA, Schaefer F, International Pediatric Peritoneal Dialysis Network Registry (2015) Risk factors for loss of residual renal function in children treated with chronic peritoneal dialysis. Kidney Int 88:605–613. https://doi.org/10.1038/ki.2015.108

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Chang TI, Ryu DR, Yoo TH, Kim HJ, Kang EW, Kim H, Chang JH, Kim DK, Moon SJ, Yoon SY, Han SH, Yonsei Associate Network Chronic Kidney Disease Trial (YACHT) investigators (2016) Effect of icodextrin solution on the preservation of residual renal function in peritoneal dialysis patients: a randomized controlled study. Med (Baltimore) 95:e2991. https://doi.org/10.1097/MD.0000000000002991

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors thank Dr. Yoshihiko Morikawa and Dr. Emi Kawaguchi Morikawa for their assistance with the statistical analyses and Mr. James Robert Valera for his assistance with editing the manuscript.

Author information

Author notes

  1. Masataka Honda & Hiroshi Hataya

    Present address: Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan

Authors and Affiliations

  1. Department of Nephrology, Tokyo Metropolitan Children’s Medical Center, Fuchu, Tokyo, Japan

    Naoaki Mikami, Riku Hamada, Ryoko Harada, Yuko Hamasaki, Kenji Ishikura, Masataka Honda & Hiroshi Hataya

  2. Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan

    Riku Hamada

  3. Department of Nephrology, Faculty of Medicine, Toho University, Ota-Ku, Tokyo, Japan

    Yuko Hamasaki

  4. Department of Pediatrics, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan

    Kenji Ishikura

  5. Department of General Pediatrics, Tokyo Metropolitan Children’s Medical Center, Fuchu, Tokyo, Japan

    Hiroshi Hataya

Authors
  1. Naoaki Mikami
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Riku Hamada
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ryoko Harada
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yuko Hamasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kenji Ishikura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masataka Honda
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hiroshi Hataya
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All the authors contributed to the study conception, data interpretation, and drafting of the manuscript, including reviewing and editing. Material preparation, methodology, data collection, and statistical analysis were performed by Naoaki Mikami and Riku Hamada. The first draft of the manuscript was written by Naoaki Mikami, and all the authors commented on previous versions of the manuscript. All the authors have read and approved the final manuscript. The corresponding author, Riku Hamada, had final responsibility for the decision to submit this manuscript for publication.

Corresponding author

Correspondence to Riku Hamada.

Ethics declarations

Ethics approval

Ethical approval was obtained from the Institutional Research Ethics Board of Tokyo Metropolitan Children’s Medical Center [H30b-173].

Consent to participate and consent for publication

No written informed consent was obtained from the patients or caregivers. Consent to participate was implied in the opt-out clause on the center’s website.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Graphical Abstract (PPTX 77 KB)

Supplementary file2 (XLSX 36 KB)

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mikami, N., Hamada, R., Harada, R. et al. Factors related to ultrafiltration volume with icodextrin dialysate use in children. Pediatr Nephrol 38, 1267–1273 (2023). https://doi.org/10.1007/s00467-022-05720-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-022-05720-0

Keywords

Search

Navigation