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.
Vychytil
Andreas
A
Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria. andreas.vychytil@meduniwien.ac.at
Remón
César
C
Michel
Catherine
C
Williams
Paul
P
Rodríguez-Carmona
Ana
A
Marrón
Belén
B
Vonesh
Ed
E
van der Heyden
Synke
S
Divino Filho
Jose C
JC
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