title: Icodextrin decreases technique failure and improves patient survival in peritoneal dialysis patients.
abstract: OBJECTIVE
  It remains unclear whether long-term daily icodextrin use can decrease technique failure and improve survival in peritoneal dialysis (PD) patients. The aim of the present study was to investigate whether icodextrin use, once daily, can decrease technique failure and prolong patient survival in incident PD patients.
  
  
  METHODS
  Incident PD patients who survived more than 90 days were recruited from the China Medical University Hospital, Taiwan, between 1 January 2007 and 31 December 2011. All patients were followed until transfer to haemodialysis (HD), renal transplantation, transfer to another centre, death, or 31 December 2011.
  
  
  RESULTS
  A total of 306 incident PD patients (89 icodextrin users, 217 icodextrin non-users) were recruited during the study period. Icodextrin users were more likely to have hypertension, diabetes and high or high-average peritoneal transport compared with non-users. During the follow-up period, 43 patients were transferred to HD: seven (7.87%) of the icodextrin group, and 36 (16.59%) of the non-icodextrin group. Thirty-two patients died during the follow-up period: five (5.62%) of the icodextrin group, and 27 (12.44%) of the non-icodextrin group. Icodextrin use was significantly associated with a better prognosis, in terms of technique failure (adjusted HR = 0.32; 95% CI = 0.14-0.72). With regard to patient survival, icodextrin use (adjusted HR = 0.33; 95% CI = 0.12-0.87) was associated with a significantly lower risk of death.
  
  
  CONCLUSIONS
  The use of icodextrin once daily may decrease technique failure and improve survival in incident PD patients.
authors.affiliation: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Department of Internal Medicine, College of Medicine, China Medical University, Taichung; Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.forename: Yu-Fen
authors.initials: YF
authors.lastname: Li
authors.forename: Jin-Hua
authors.initials: JH
authors.lastname: Chen
authors.forename: Chih-Chia
authors.initials: CC
authors.lastname: Liang
authors.forename: Yao-Lung
authors.initials: YL
authors.lastname: Liu
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Lin
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Tsai
authors.forename: Tzung-Hai
authors.initials: TH
authors.lastname: Yen
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D015314:Dialysis Solutions / Q000627:therapeutic use*; D005260:Female; D005936:Glucans / Q000627:therapeutic use*; D005947:Glucose / Q000627:therapeutic use*; D006801:Humans; D000077607:Icodextrin; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D015314:Dialysis Solutions; D005936:Glucans; D000077607:Icodextrin; D005947:Glucose
keywords: End-stage renal disease; icodextrin; patient survival; peritoneal dialysis; technique survival