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Two icodextrin exchanges per day in peritoneal dialysis patients with ultrafiltration failure: one center's experience and review of the literature.
MedLine Citation:
PMID:  20953705     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: At present, only one exchange of an icodextrin-based solution is recommended to increase peritoneal ultrafiltration (UF) during long-dwell exchanges in peritoneal dialysis (PD) patients with impaired UF.
AIM: To review our experience with two icodextrin exchanges per day on net UF and body weight in PD patients with poor UF.
METHODS: Data were analyzed on nine patients with poor UF on chronic PD who were given two icodextrin exchanges per day for 6 months and had various clinical and biochemical parameters assessed monthly.
RESULTS: Administration of icodextrin twice daily reduced the body weight in six of nine patients by an average of 2.9 ± 1.2 kg, a reduction that was maintained throughout the study; two patients gained 0.5 kg; and, in one patient, the measurements were inadequate. Mean blood pressure was reduced. Mean serum creatinine increased slightly. Serum sodium levels decreased from a mean baseline level of 134 ± 3 to 132 ± 4 mmol/L at three and six months. Among the diabetics in this group, average daily insulin requirements were 44 ± 35 units/day at baseline and 40 ± 23 units/day after 6 months. Hb1Ac levels remained stable throughout the study period.
CONCLUSION: The use of two icodextrin exchanges per day reduced body weight in six of the nine patients and appeared to be safe. Long-term prospective studies are needed to assess the contribution of twice-daily icodextrin to the management of peritoneal dialysis patients with ultrafiltration failure and its long-term safety.
Authors:
Periklis Dousdampanis; Konstantza Trigka; Maggie Chu; Saimah Khan; Daniele Venturoli; Dimitrios G Oreopoulos; Joanne M Bargman
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Publication Detail:
Type:  Journal Article     Date:  2010-02-21
Journal Detail:
Title:  International urology and nephrology     Volume:  43     ISSN:  1573-2584     ISO Abbreviation:  Int Urol Nephrol     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0262521     Medline TA:  Int Urol Nephrol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  203-9     Citation Subset:  IM    
Affiliation:
University of Toronto, Toronto General Hospital, 200 Elizabeth Street, 8N-840, Toronto, ON, M5G 2C4, Canada.
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