Icodextrin does not impact infectious and culture-negative peritonitis rates in peritoneal dialysis patients: a 2-year multicentre, comparative, prospective cohort study.
BACKGROUND
Icodextrin is a glucose polymer derived by hydrolysis of cornstarch. The different biocompatibility profile of icodextrin-containing peritoneal dialysis (PD) solutions may have a positive influence on peritoneal host defence. Furthermore, cases of sterile peritonitis potentially associated with icodextrin have been reported.


METHODS
The primary objective of this multicentre, longitudinal, observational, non-interventional, prospective cohort study, which included 722 PD patients, was to evaluate the incidence of overall peritonitis in patients treated with icodextrin-containing PD solutions (Extraneal) used during one long-dwell exchange/day compared with those treated with non-icodextrin-containing PD solutions. The secondary objective was to determine if culture-negative peritonitis rates differed between patients treated with icodextrin from two independent manufacturers. All peritonitis episodes were assessed by a Steering Committee in a blind manner.


RESULTS
There was no significant difference between icodextrin-treated and control patients in the adjusted overall, culture-positive or culture-negative peritonitis rates. When stratified by the icodextrin supplier, there was no significant difference in the adjusted rate of culture-negative peritonitis episodes between groups.


CONCLUSIONS
Subjects receiving icodextrin as part of their PD regimen experienced neither a higher rate of culture-negative peritonitis nor a lower rate of infectious peritonitis compared with non-icodextrin users. There was no significant influence of the icodextrin raw material supplier on peritonitis rates.
Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria. andreas.vychytil@meduniwien.ac.at
Andreas
A
Vychytil
César
C
Remón
Catherine
C
Michel
Paul
P
Williams
Ana
A
Rodríguez-Carmona
Belén
B
Marrón
Ed
E
Vonesh
Synke
S
van der Heyden
Jose C
JC
Divino Filho
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D015314:Dialysis Solutions / Q000627:therapeutic use*; D005060:Europe; D005260:Female; D005936:Glucans / Q000627:therapeutic use*; D005947:Glucose / Q000627:therapeutic use*; D006801:Humans; D000077607:Icodextrin; D007674:Kidney Diseases / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010538:Peritonitis / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
D015314:Dialysis Solutions; D005936:Glucans; D000077607:Icodextrin; D005947:Glucose