Modeling of icodextrin in PD Adequest 2.0.
OBJECTIVE
To validate the use of a modified three-pore model for predicting fluid transport during long dwell exchanges that use a 7.5% icodextrin solution.


METHODS
A nonrandomized, single group, repeated measures study.


METHODS
Ten peritoneal dialysis patients underwent a single 8-hour exchange of a 7.5% icodextrin solution. All patients were naive to icodextrin.


METHODS
A modified three-pore model was used to model solute and fluid transport during each 8-hour exchange. Concordance correlation coefficients were used to estimate the level of agreement between modeled and measured values of net ultrafiltration (UF) and intraperitoneal volume.


METHODS
Each patient underwent a modified 8-hour standard peritoneal permeability analysis using a 2-L 7.5% icodextrin exchange. Dextran 70 was added to the icodextrin solution as volume marker to estimate fluid transport kinetics. Transcapillary UF, fluid absorption, and intraperitoneal volumes were assessed via the volume marker at 0, 5, 15, 30, 60, 120, 240, 300, 360, 420, and 480 minutes.


RESULTS
There was strong agreement (concordance correlation = 0.9856) between net UF as measured by the volume marker data and net UF as modeled using the modified three-pore model implemented in PD Adequest (Baxter Healthcare, Deerfield, Illinois, USA).


CONCLUSIONS
Net UF and intraperitoneal volumes for long dwell exchanges using a 7.5% icodextrin solution can be accurately modeled with a modified three-pore model. Steady state icodextrin plasma levels are needed to accurately predict net UF for chronic users of icodextrin.
Vonesh
Edward F
EF
Statistics, Epidemiology and Surveillance, Baxter Healthcare Corporation, Route 120 & Wilson Road, Round Lake, Illinois 60073, USA. voneshe@baxter.com
Story
Kenneth O
KO
Douma
Caroline E
CE
Krediet
Raymond T
RT
D005936:Glucans / Q000493:pharmacokinetics*; D005947:Glucose / Q000493:pharmacokinetics*; D015312:Hemodialysis Solutions; D006801:Humans; D000077607:Icodextrin; D007700:Kinetics; D008657:Metabolic Clearance Rate; D008954:Models, Biological; D010530:Peritoneal Dialysis / Q000379:methods*; D010537:Peritoneum; D010539:Permeability
D005936:Glucans; D015312:Hemodialysis Solutions; D000077607:Icodextrin; D005947:Glucose