The kinetics of water transperitoneal transport during long-term peritoneal dialysis performed using icodextrin dialysis fluid.
BACKGROUND
Dialysis fluid containing icodextrin is used in patients on peritoneal dialysis (PD) because of its significant ultrafiltration properties. The use of the fluid in treating patients with congestive heart failure resistant to diuretics has also been reported.


OBJECTIVE
The aim of the study was to evaluate water peritoneal transport during a 16-hour dialysis exchange performed using icodextrin-containing dialysis fluid.


METHODS
Eleven clinically stable patients were enrolled in the study (5 women and 6 men; mean age, 50.4 +/- 18.3 years), treated with PD for 26.9 +/- 22.4 months. Water transperitoneal transport was evaluated using a modified version of Babb-Randerson-Farrell thermodynamic model of membrane transport with human albumin marked with iodine as the marker of intraperitoneal volume. Based on blood and dialysate samples collected during the 16-hour dialysis exchange, the intraperitoneal volume of dialysate and dialysate reverse absorption were calculated.


RESULTS
There were no clinical complications associated with the use of icodextrin fluid during the study. A significant increase in intraperitoneal volume of dialysate (950 ml on average) compared to the initial value was observed in the whole group at the 16th hour of the exchange.


CONCLUSIONS
The study demonstrated that dialysis fluid with icodextrin ensured effective ultrafiltration during a 16-hour dialysis exchange. This indicates its potential usefulness in the treatment of patients with severe congestive heart failure with or without coexisting end-stage renal disease.
Olszowska
Anna
A
Department of Internal Diseases, Nephrology and Dialysotherapy, Military Medicine Institute, Central Hospital of the Ministry of Public Defence, Warszawa, Poland.
Zelichowski
Grzegorz
G
Waniewski
Jacek
J
Stachowska-Pietka
Joanna
J
Weryński
Andrzej
A
Wańkowicz
Zofia
Z
D000368:Aged; D001693:Biological Transport, Active; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D005936:Glucans / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005947:Glucose / Q000008:administration & dosage / Q000493:pharmacokinetics*; D015312:Hemodialysis Solutions / Q000008:administration & dosage / Q000493:pharmacokinetics*; D006801:Humans; D000077607:Icodextrin; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods*; D010537:Peritoneum / Q000187:drug effects
D001786:Blood Glucose; D005936:Glucans; D015312:Hemodialysis Solutions; D000077607:Icodextrin; D005947:Glucose