Effects of twice-daily icodextrin administration on blood pressure and left ventricular mass in patients on continuous ambulatory peritoneal dialysis.
BACKGROUND
Hypervolemia is a risk factor for left ventricular hypertrophy and hypertension in peritoneal dialysis patients. Icodextrin improves volume control by increasing ultrafiltration in peritoneal dialysis patients.


OBJECTIVE
To examine the effects of twice-daily icodextrin administration on blood pressure and left ventricular hypertrophy in peritoneal dialysis patients with hypervolemia and ultrafiltration failure.


RESULTS
Administration of icodextrin twice daily resulted in a significant reduction in the left ventricular mass index (LVMI) of patients by the end of the third month (p < 0.05). The reduction in LVMI was also significant for the once-daily icodextrin group (p < 0.05). Mean blood pressure of patients receiving icodextrin twice daily was significantly reduced (p < 0.05). By the end of the third month no significant changes were observed in mean blood pressure of the patients using once-daily icodextrin (p > 0.05). No statistically significant changes were observed in weekly total creatinine clearances or Kt/V of patients in either group at the end of 3 months (NS).


CONCLUSIONS
Twice-daily icodextrin administration was clinically beneficial as shown by reduced blood pressure and prevention of the progress of left ventricular hypertrophy without causing any decrease in dialysis adequacy or any side effects. The icodextrin metabolite results did not suggest any further increase in their values when comparing once- to twice-daily administration of icodextrin. Although prescription of icodextrin once daily may yield good clinical results in the long term, this study showed that it may be more efficient to use twice-daily icodextrin for at least a specific period for the purpose of obtaining quicker results in patients with ultrafiltration failure, serious hypervolemia, or hard-to-control blood pressure conditions.
Sav
Tansu
T
Department of Nephrology, Government Hospital, Erciyes University, Kayseri, Turkey. savtansu@hotmail.com
Oymak
Oktay
O
Inanc
Mehmet Tugrul
MT
Dogan
Ali
A
Tokgoz
Bulent
B
Utas
Cengiz
C
D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D004334:Drug Administration Schedule; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects; D005936:Glucans / Q000008:administration & dosage*; D005947:Glucose / Q000008:administration & dosage*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000187:drug effects*; D015312:Hemodialysis Solutions / Q000008:administration & dosage*; D006801:Humans; D000077607:Icodextrin; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
D005936:Glucans; D015312:Hemodialysis Solutions; D000077607:Icodextrin; D005947:Glucose