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Randomized Controlled Trial
. 2009 Nov;4(11):1799-804.
doi: 10.2215/CJN.02950509. Epub 2009 Oct 1.

Randomized controlled trial of icodextrin versus glucose containing peritoneal dialysis fluid

Aiwu Lin  1 , Jiaqi Qian, Xiaomei Li, Xueqing Yu, Wenhu Liu, Yang Sun, Nan Chen, Changlin Mei; Icodextrin National Multi-center Cooperation Group
Collaborators, Affiliations
Randomized Controlled Trial

Randomized controlled trial of icodextrin versus glucose containing peritoneal dialysis fluid

Aiwu Lin et al. Clin J Am Soc Nephrol. 2009 Nov.

Abstract

Background and objectives: While peritoneal dialysis with icodextrin is commonly used in patients with poor peritoneal membrane characteristics, the data on the usefulness of this solution in patients with lower transport characteristics are limited. The study was designed to compare icodextrin to glucose in Chinese prevalent peritoneal dialysis patients of different peritoneal transport characteristics (PET) categories.

Design, setting, participants, & measurements: This was a randomized, double-blind, perspective control study. Stable prevalent continuous ambulatory peritoneal dialysis (CAPD) patients were randomized to either 7.5% icodextrin (ICO) or 2.5% glucose (GLU) solution for 4 wk. Peritoneal membrane function was measured to define PET category in baseline. Creatinine clearance (Ccr), urea nitrogen clearance (C(BUN)), ultrafiltration (UF) during the long night dwell, dialysate, and metabolic biomarkers were measured at baseline, 2, and 4 wk. UF, Ccr, and C(BUN) were compared among different PET categories.

Results: A total of 201 CAPD patients were enrolled in the study. There were no baseline differences between the groups. Following 2 and 4 wk of therapy, Ccr, C(BUN,) and UF were all significantly higher in the ICO versus the GLU group. Additionally, switching to ICO resulted in a significant increase in UF in high, high-average, and low-average transporters as compared with baseline. The extent of increased UF was more obvious in higher transporters. Blood cholesterol level in the ICO group decreased significantly than that in the GLU group.

Conclusion: Compared with glucose-based solution, 7.5% icodextrin significantly improved UF and small solute clearance, even in patients with low-average peritoneal transport.

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Figures

Figure 1.
Figure 1.
The flow of study subjects in the study.
Figure 2.
Figure 2.
Significant difference in long dwell ultrafiltration volume between the groups and after 4 wk of therapy. Compared with baseline, the long dwell ultrafiltration volume increased significantly in the ICO group and was greater than that of the GLU group.
Figure 3.
Figure 3.
Long dwell ultrafiltration volume in the different PET categories after 4 wk of therapy and grouped according to solution.
See this image and copyright information in PMC

References

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