Beneficial effects of icodextrin on plasma level of adipocytokines in peritoneal dialysis patients.
OBJECTIVE
Leptin and adiponectin, well-recognized adipocytokines, are reported to contribute to the pathogenesis of atherosclerosis. The aim of this study was to elucidate the effects of icodextrin-based dialysis solution on adipocytokine metabolism.


METHODS
In 12 non-diabetic anuric patients on peritoneal dialysis, dialysis solution was changed from glucose-based dialysis solution to icodextrin-based dialysis solution for 6 months. Plasma levels of leptin, adiponectin, lipids (total cholesterol, HDL-cholesterol and triglyceride), insulin, blood glucose and insulin sensitivity index by the homeostasis model assessment (HOMA-IR) were compared before and after the use of the icodextrin solution.


RESULTS
Plasma leptin level was decreased from 15.6 (2.5-69.0) to 7.3 (2.9-45.9) ng/ml (P = 0.018) and plasma adiponectin level increased from 11.6 (6.2-19.6) to 17.6 (7.8-33.0) microg/ml (P = 0.002). A reduction in plasma insulin level from 33.1 (13.8-54.1) to 19.1 (5.8-37.3) muU/ml (P = 0.009) and HOMA-IR from 8.22 (3.68-15.09) to 5.15 (1.40-13.78) (P = 0.015) was observed. While plasma total cholesterol level remained similar, HDL-cholesterol level increased, from 36.0 (22-45) to 43.5 (30-69) mg/dl (P = 0.008) and the triglyceride level decreased, from 174.0 (140-250) to 116.5 (81-207) mg/dl (P = 0.012).


CONCLUSIONS
Icodextrin-based dialysis solution improves abnormal adipocytokine metabolism, dyslipidaemia and insulin resistance, which are known to be associated with atherosclerosis. These results suggest that the use of icodextrin-based dialysis solution might be useful in preventing atherosclerosis in PD patients. Long-term effects of icodextrin-based dialysis solution on the atherosclerosis in peritoneal dialysis patients should be tested.
Furuya
Ryuichi
R
Department of Internal Medicine, Iwata City Hospital, Iwata, Japan. r-furuya@isis.ocn.ne.jp
Odamaki
Mari
M
Kumagai
Hiromichi
H
Hishida
Akira
A
D052242:Adiponectin / Q000097:blood*; D005260:Female; D005936:Glucans / Q000627:therapeutic use*; D005947:Glucose / Q000627:therapeutic use*; D015312:Hemodialysis Solutions / Q000627:therapeutic use*; D006801:Humans; D000077607:Icodextrin; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis
D052242:Adiponectin; D005936:Glucans; D015312:Hemodialysis Solutions; D020738:Leptin; D000077607:Icodextrin; D005947:Glucose