Clinical experience with icodextrin in children: ultrafiltration profiles and metabolism.
Icodextrin use in adults provides sustained ultrafiltration (UF) in long-term dwells. No information is available on UF and metabolism in children. In 11 children, a volume of 1,049+/-138 ml/m2 of the study fluid (1.36% glucose, 7.5% icodextrin, 3.86% glucose) was administered for 12 h. Net UF with icodextrin (339+/-147 ml/1.73 m2) did not differ from UF with 3.86% glucose (450+/-306 ml/1.73 m2, P=0.53) and was higher than UF with 1.36% glucose (-87+/-239 ml/1.73 m2, P=0.003). Icodextrin added 0.52+/-0.07 to the weekly Kt/V. Over 6 weeks, icodextrin was used for 12-h daytime dwell. Total icodextrin reached a steady-state level of 2.91+/-1.22 g/l at 2 weeks. The main icodextrin metabolites were maltose, maltotriose, and maltotetraose. After 2 weeks, steady state levels were 2.02+/-0.66 mmol/l, 1.46+/-0.35 mmol/l, and 0.45+/-0.12 mmol/l. No icodextrin or metabolites were detectable 4 weeks after the study. We conclude that 7.5% icodextrin is capable of maintaining UF during 12-h dwell in children and is comparable to UF obtained with 3.86% glucose. Steady-state levels of icodextrin and metabolites were reached at 2 weeks and disappeared after the study.
de Boer
A W
AW
Department of Pediatrics, University Hospital Nijmegen, The Netherlands.
Schröder
C H
CH
van Vliet
R
R
Willems
J L
JL
Monnens
L A
LA
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D015314:Dialysis Solutions; D005260:Female; D005936:Glucans / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005947:Glucose / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D000077607:Icodextrin; D008297:Male; D008320:Maltose / Q000031:analogs & derivatives / Q000097:blood; D009844:Oligosaccharides / Q000097:blood; D010530:Peritoneal Dialysis; D014462:Ultrafiltration
D001786:Blood Glucose; D015314:Dialysis Solutions; D005936:Glucans; D009844:Oligosaccharides; D000077607:Icodextrin; D008320:Maltose; C009819:maltotetraose; D005947:Glucose