Document Detail


Effects of icodextrin in automated peritoneal dialysis on blood pressure and bioelectrical impedance analysis.
MedLine Citation:
PMID:  10831642     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Glucose absorption from glucose-based dialysis fluids limits ultrafiltration from the daytime dwell in automated peritoneal dialysis (APD). Icodextrin may allow greater ultrafiltration during the daytime period in APD, enhancing fluid control. METHODS: A 7.5% icodextrin dialysate was compared with a 2. 27% glucose dialysate for the daytime dwell in 14 subjects on APD. Blood pressure, weight and body water compartments estimated by multifrequency bioelectrical impedance (MFBIA) were determined in subjects using 2.27% glucose as the daytime dwell and then repeated 1 month after switching to icodextrin. RESULTS: Icodextrin resulted in symptomatic hypotension requiring reduction of antihypertensive medication in six of the 14 patients. Despite this reduction in treatment, systolic blood pressure fell from 142.4 (23.9) mmHg to 122.9 (17.7) mmHg, P<0.005, and diastolic blood pressure tended to fall from 82.8 (9.8) mmHg to 76.8 (10.1) mmHg, P=0.075. Change in systolic blood pressure significantly correlated with changes in weight (r=0.62, P<0.05) and MFBIA estimates of total body water (TBW) (r=0.56, P<0.05), extracellular water (ECW) (r=0.79, P<0.002), extra/intracellular water ratio (ECW/ICW) (r=0.72, P<0.01) and derived resistances R(ecf) of ECW (r=-0.69, P<0.01) and R(inf) of TBW (r=-0.66, P<0.02). Changes in diastolic blood pressure significantly correlated with changes in ECW (r=0.64, P<0.02) and ECW/ICW ratio (r=0.58, P<0.05), and almost significantly with R(ecf) (r=-0.51, P=0.08) and R(inf) (r=-0.52, P=0.07) estimated by MFBIA, but not with changes in weight or TBW. CONCLUSIONS: Use of icodextrin for the daytime dwell in APD results in improved fluid balance and blood pressure control compared with 2.27% glucose. MFBIA detected clinically important changes in fluid content in these patients.
Authors:
G Woodrow; B Oldroyd; G Stables; J Gibson; J H Turney; A M Brownjohn
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  15     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-07-10     Completed Date:  2000-07-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  862-6     Citation Subset:  IM    
Affiliation:
Renal Unit, Leeds General Infirmary and. Centre for Bone and Body Composition Research, University of Leeds, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antihypertensive Agents / therapeutic use
Automation
Blood Pressure / drug effects*
Body Composition / drug effects
Body Weight / drug effects
Dialysis Solutions / analysis
Electric Impedance
Female
Glucans / pharmacokinetics,  pharmacology*
Glucose / pharmacokinetics,  pharmacology*
Humans
Male
Middle Aged
Peritoneal Dialysis*
Regression Analysis
Systole / drug effects
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Dialysis Solutions; 0/Glucans; 0/icodextrin; 50-99-7/Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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