title: Icodextrin improves the serum potassium profile with the enhancement of nutritional status in continuous ambulatory peritoneal dialysis patients.
abstract: The impact of glucose-free icodextrin (ID) for overnight dwell as compared to conventional glucose-containing dialysate (GD) on potassium (K(+)) metabolism in continuous ambulatory peritoneal dialysis (CAPD) patients has not yet been investigated. Serum K(+) in a total of 255 stable patients (116 on GD and 139 on ID) on CAPD for more than 6 months and in 139 patients on ID before and after ID use (Pre-ID and Post-ID) were observed along with nutritional markers in a 2-year study period (Jan. 2006 to Dec. 2007). The prevalence of hypokalemia was similar between patients on GD and ID (16.7% vs 17.3%), but was lower on Post-ID than Pre-ID (17.3% vs 20.5%) without statistic significance. The mean serum K(+) level was higher on ID than on GD (P<0.05) as well as Post-ID than Pre-ID (P<0.001). In the multivariate analysis, serum K(+) levels were positively correlated with serum albumin, and creatinine in all patients (P<0.05), and ID-use in younger patients (age≤56, P<0.001). Serum albumin, creatinine, total CO(2), and body mass index were significantly higher on Post-ID than Pre-ID. Icodextrin dialysate for chronic overnight dwell could increase serum K(+) levels and lower the prevalence of hypokalemia compared to conventional glucose-containing dialysate. The improved chronic K(+) balance in CAPD patients on icodextrin could be related to enhanced nutritional status rather than its impact on acute intracellular K(+) redistribution.
authors.affiliation: Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
authors.forename: Joo-Hark
authors.initials: JH
authors.lastname: Yi
authors.forename: Jae-Il
authors.initials: JI
authors.lastname: Park
authors.forename: Hoon-Young
authors.initials: HY
authors.lastname: Choi
authors.forename: Ho-Yung
authors.initials: HY
authors.lastname: Lee
authors.forename: Sang-Woong
authors.initials: SW
authors.lastname: Han
authors.forename: Ho-Jung
authors.initials: HJ
authors.lastname: Kim