Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Oct 25;19(1):293.
doi: 10.1186/s12882-018-1071-6.

Icodextrin-associated generalized exfoliative skin rash in a CAPD patient: a case-report

Vassilios Liakopoulos  1 , Panagiotis I Georgianos  2 , Paraskevi Demirtzi  2 , Vasilios Vaios  2 , Theofanis Kalathas  2 , Pantelis E Zebekakis  2
Affiliations
Case Reports

Icodextrin-associated generalized exfoliative skin rash in a CAPD patient: a case-report

Vassilios Liakopoulos et al. BMC Nephrol. .

Abstract

Background: Icodextrin is a starch-derived, water soluble glucose polymer, which is used as an alternative to glucose in order to enhance dialytic fluid removal in peritoneal dialysis patients. Although the safety and efficacy of icodextrin is well-established, its use in everyday clinical practice has been associated with the appearance of skin rashes and other related skin reactions.

Case presentation: Herein, we report the rare case of a 91-year-old woman with a history of severe congestive heart failure, who initiated continuous ambulatory peritoneal dialysis with icodextrin-based dialysate solutions and 15 days after the initial exposure to icodextrin developed a generalized maculopapular and exfoliative skin rash extending over the back, torso and extremities. Discontinuation of icodextrin and oral therapy with low-dose methyl-prednisolone with quick dose tapering improved the skin lesions within the following days.

Conclusions: This case report highlights that skin hypersensitivity is a rare icodextrin-related adverse event that should be suspected in patients manifesting skin reactions typically within a few days or weeks after the initial exposure.

Keywords: Hypersensitivity; Icodextrin; Peritoneal dialysis; Skin rash.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The Ethics Committee of the AHEPA University Hospital of Thessaloniki approved of the case-report submitted. Patient consent was formally waived by the Ethics Committee as requirement for approval.

Consent for publication

Written informed consent was obtained from the patient’s daughter for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor of this journal.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

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

Figures

Fig. 1
Fig. 1
a Generalized exfoliative skin rash over the torso and upper extermities; b exfoliative skin rash in the back
See this image and copyright information in PMC

References

    1. van Biesen W, Heimburger O, Krediet R, Rippe B, La Milia V, Covic A, Vanholder R, ERBP working group on peritoneal dialysis Evaluation of peritoneal membrane characteristics: clinical advice for prescription management by the ERBP working group. Nephrol Dial Transplant. 2010;25:2052–2062. doi: 10.1093/ndt/gfq100. - DOI - PubMed
    1. Silver SA, Harel Z, Perl J. Practical considerations when prescribing icodextrin: a narrative review. Am J Nephrol. 2014;39:515–527. doi: 10.1159/000363417. - DOI - PubMed
    1. Cho Y, Johnson DW, Badve S, Craig JC, Strippoli GF, Wiggins KJ. Impact of icodextrin on clinical outcomes in peritoneal dialysis: a systematic review of randomized controlled trials. Nephrol Dial Transplant. 2013;28:1899–1907. doi: 10.1093/ndt/gft050. - DOI - PubMed
    1. Queffeulou G, Lebrun-Vignes B, Wheatley P, Montagnac R, Mignon F. Allergy to icodextrin. Lancet. 2000;356:75. doi: 10.1016/S0140-6736(05)73411-5. - DOI - PubMed
    1. Wolfson M, Piraino B, Hamburger RJ, Morton AR. A randomized controlled trial to evaluate the efficacy and safety of icodextrin in peritoneal dialysis. Am J Kidney Dis. 2002;40:1055–1065. doi: 10.1053/ajkd.2002.36344. - DOI - PubMed

Publication types

MeSH terms