title: Icodextrin eliminates phosphate and ameliorates cardiac hypertrophy and valvular calcification in patients with end-stage renal disease and diabetes mellitus undergoing peritoneal dialysis.
abstract: Among end-stage renal disease (ESRD) patients, cardiovascular disease is a common comorbidity and one of most important factors affecting clinical prognosis. Calcium deposition has been reported to correlate with plasma phosphate. Icodextrin (Ico)-based peritoneal dialysis (PD) has many advantages over glucose (Glu)-based PD. We aimed to identify factors that suppress arteriosclerosis and valvular disease in patients with ESRD and diabetes mellitus (DM) undergoing Ico-based PD. In this retrospective study, we evaluated the effects of Ico-based PD (n = 20) on phosphate elimination and cardiovascular disease progression in patients with ESRD andDM, and we compared the results with those for Glu-based PD (n = 20). Left ventricular mass index (LVMI) and aortic valve calcification (AVC) score were significantly decreased and daily phosphate elimination was significantly increased in the Ico group compared with the Glu group. Furthermore, mean daily phosphate elimination was significantly and negatively correlated with the amelioration in LVMI and AVC score. Our study suggests that, compared with glucose, icodextrin has the ability to eliminate more phosphate from the body, indicating that phosphate elimination might potentially be a means of controlling cardiovascular disease in PD patients with DM.
authors.affiliation: Department of Nephrology, Aichi Welfare Cooperative Agricultural Konan-Kosei Hospital, Aichi, Tokyo, Japan. t-hiramatsu@konan.jaaikosei.or.jp
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Hiramatsu
authors.affiliation: Department of Nephrology, Aichi Welfare Cooperative Agricultural Konan-Kosei Hospital, Aichi, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hayasaki
authors.affiliation: Department of Nephrology, Aichi Welfare Cooperative Agricultural Konan-Kosei Hospital, Aichi, Tokyo, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Hobo
authors.affiliation: Department of Nephrology, Aichi Welfare Cooperative Agricultural Konan-Kosei Hospital, Aichi, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Furuta
authors.affiliation: Baxter Ltd., Tokyo, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Kabu
authors.affiliation: Baxter Ltd., Tokyo, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Tonozuka
authors.affiliation: Department of Nephrology, Aichi Welfare Cooperative Agricultural Konan-Kosei Hospital, Aichi, Tokyo, Japan.
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Iida
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000517:prevention & control; D006332:Cardiomegaly / Q000517:prevention & control*; D003324:Coronary Artery Disease / Q000517:prevention & control*; D003928:Diabetic Nephropathies; D018450:Disease Progression; D005260:Female; D005936:Glucans / Q000627:therapeutic use*; D005947:Glucose / Q000627:therapeutic use*; D006349:Heart Valve Diseases / Q000517:prevention & control*; D006351:Heart Valves / Q000473:pathology; D015312:Hemodialysis Solutions / Q000627:therapeutic use*; D006801:Humans; D054559:Hyperphosphatemia / Q000517:prevention & control; D000077607:Icodextrin; D007676:Kidney Failure, Chronic; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D005936:Glucans; D015312:Hemodialysis Solutions; D010710:Phosphates; D000077607:Icodextrin; D005947:Glucose