title: What is the optimal dwell time for maximizing ultrafiltration with icodextrin exchange in automated peritoneal dialysis patients?
abstract: BACKGROUND
  Icodextrin is increasingly being used in automated peritoneal dialysis (APD) for the long dwell exchange to maintain adequate ultrafiltration (UF). However, the UF reported in the literature varies with different dwell times: from 200 to 500 mL with 12 - 15 hour dwells. In order to maximize UF, it is important to know the relationship between dwell time and UF when using icodextrin in APD patients. With this knowledge, decisions can be made with respect to dwell period, and adjustments to the dialysis prescription can be made accordingly.
  
  
  METHODS
  We prospectively studied this relationship in 36 patients from Canada and Turkey. All patients did the icodextrin day exchange manually after disconnecting themselves from overnight cycler dialysis. Dwell period was increased by 1 hour every week, from 10 to 14 hours. Ultrafiltration was noted for each icodextrin exchange. Mean UF for each week (i.e., dwell period) was compared by repeated measures ANOVA.
  
  
  RESULTS
  We found no difference in mean UF with increasing dwelt time: 351.73 +/- 250.59 mL at 10 hours versus 371.75 +/- 258.25 mL at 14 hours (p = 0.83). We also compared mean UF between different subgroups and found that males (p = 0.02 vs females) and high transporters (p = 0.04 vs low) had higher mean UF. Further analysis of maximal UF showed no correlation to age, sex, diabetic status, transport category, creatinine clearance, Kt/V, duration on peritoneal dialysis, or duration of icodextrin use.
  
  
  CONCLUSIONS
  Icodextrin-related UF in APD patients is not related to demographic factors and does not increase significantly beyond 10 hours.
authors.affiliation: University of Toronto, Canada.
authors.forename: Tarun K
authors.initials: TK
authors.lastname: Jeloka
authors.forename: Fevzi F
authors.initials: FF
authors.lastname: Ersoy
authors.forename: Mahmut
authors.initials: M
authors.lastname: Yavuz
authors.forename: Krishna M
authors.initials: KM
authors.lastname: Sahu
authors.forename: Taner
authors.initials: T
authors.lastname: Camsari
authors.forename: Cengiz
authors.initials: C
authors.lastname: Utaş
authors.forename: Semra
authors.initials: S
authors.lastname: Bozfakioglu
authors.forename: Cetin
authors.initials: C
authors.lastname: Ozener
authors.forename: Kenan
authors.initials: K
authors.lastname: Ateş
authors.forename: Rezzan
authors.initials: R
authors.lastname: Ataman
authors.forename: Fehmi
authors.initials: F
authors.lastname: Akçiçek
authors.forename: Tekin
authors.initials: T
authors.lastname: Akpolat
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Karayaylali
authors.forename: Turgay
authors.initials: T
authors.lastname: Arinsoy
authors.forename: Emin Yilmaz
authors.initials: EY
authors.lastname: Mehmet
authors.forename: Gültekin
authors.initials: G
authors.lastname: Süleymanlar
authors.forename: Dorothy
authors.initials: D
authors.lastname: Burdzy
authors.forename: Dimitrios G
authors.initials: DG
authors.lastname: Oreopoulos
mesh_terms: D000328:Adult; D000368:Aged; D001331:Automation / Q000379:methods*; D002170:Canada; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods*; D014421:Turkey; D014462:Ultrafiltration