Randomized controlled trial of icodextrin versus glucose containing peritoneal dialysis fluid.
OBJECTIVE
While peritoneal dialysis with icodextrin is commonly used in patients with poor peritoneal membrane characteristics, the data on the usefulness of this solution in patients with lower transport characteristics are limited. The study was designed to compare icodextrin to glucose in Chinese prevalent peritoneal dialysis patients of different peritoneal transport characteristics (PET) categories.


METHODS
This was a randomized, double-blind, perspective control study. Stable prevalent continuous ambulatory peritoneal dialysis (CAPD) patients were randomized to either 7.5% icodextrin (ICO) or 2.5% glucose (GLU) solution for 4 wk. Peritoneal membrane function was measured to define PET category in baseline. Creatinine clearance (Ccr), urea nitrogen clearance (C(BUN)), ultrafiltration (UF) during the long night dwell, dialysate, and metabolic biomarkers were measured at baseline, 2, and 4 wk. UF, Ccr, and C(BUN) were compared among different PET categories.


RESULTS
A total of 201 CAPD patients were enrolled in the study. There were no baseline differences between the groups. Following 2 and 4 wk of therapy, Ccr, C(BUN,) and UF were all significantly higher in the ICO versus the GLU group. Additionally, switching to ICO resulted in a significant increase in UF in high, high-average, and low-average transporters as compared with baseline. The extent of increased UF was more obvious in higher transporters. Blood cholesterol level in the ICO group decreased significantly than that in the GLU group.


CONCLUSIONS
Compared with glucose-based solution, 7.5% icodextrin significantly improved UF and small solute clearance, even in patients with low-average peritoneal transport.
Lin
Aiwu
A
Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai 200001, P. R. China.
Qian
Jiaqi
J
Li
Xiaomei
X
Yu
Xueqing
X
Liu
Wenhu
W
Sun
Yang
Y
Chen
Nan
N
Mei
Changlin
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015314:Dialysis Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005936:Glucans / Q000008:administration & dosage* / Q000009:adverse effects; D005947:Glucose / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D000077607:Icodextrin; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods*; D010537:Peritoneum / Q000378:metabolism; D010538:Peritonitis / Q000209:etiology / Q000378:metabolism; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D015314:Dialysis Solutions; D005936:Glucans; D000077607:Icodextrin; D005947:Glucose