Superiority of Icodextrin Compared with 4.25% Dextrose for Peritoneal Ultrafiltration

Finkelstein, Fredric, Healy, Helen, Abu-Alfa, Ali, Ahmad, Suhail, Brown, Fiona, Gehr, Todd, Nash, Kevin, Sorkin, Michael, Mujais, Salim, Johnson, David and Icodextrin High Transporter Trial Group (2005) Superiority of Icodextrin Compared with 4.25% Dextrose for Peritoneal Ultrafiltration. Journal of the American Society of Nephrology., 16 2: 546-554. doi:10.1681/ASN.2004090793

Author Finkelstein, Fredric
Healy, Helen
Abu-Alfa, Ali
Ahmad, Suhail
Brown, Fiona
Gehr, Todd
Nash, Kevin
Sorkin, Michael
Mujais, Salim
Johnson, David
Icodextrin High Transporter Trial Group
Title Superiority of Icodextrin Compared with 4.25% Dextrose for Peritoneal Ultrafiltration
Journal name Journal of the American Society of Nephrology.   Check publisher's open access policy
ISSN 1046-6673
Publication date 2005-01-01
Sub-type Article (original research)
DOI 10.1681/ASN.2004090793
Open Access Status DOI
Volume 16
Issue 2
Start page 546
End page 554
Total pages 9
Place of publication Washington, DC, United States
Publisher American Society of Nephrology
Language eng
Subject 110312 Nephrology and Urology
Formatted abstract
Several clinical observations suggest the superiority of icodextrin compared with 4.25% dextrose in optimizing peritoneal ultrafiltration (UF), but no rigorous controlled evaluation has hitherto been performed. For comparing icodextrin and 4.25% dextrose during the long dwell of automated peritoneal dialysis, a multicenter, randomized, double-blind trial was conducted in 92 patients (control, 45; icodextrin, 47) with 4-h dialysate to plasma ratio creatinine >0.70 and D/D0 glucose <0.34.

Long-dwell net UF and the UF efficiency ratio (net UF volume per gram of dialysate carbohydrate absorbed) were determined at baseline, week 1, and week 2. The control and treatment groups were comparable at baseline (all patients using 4.25% dextrose for the long dwell) with regard to mean (±SEM) net UF (201.7 ± 103.1 versus 141.6 ± 75.4 ml, respectively; P = 0.637) and the percentage of patients with negative net UF (control, 37.8%; treatment, 42.6%; P = 0.641). During the study period, net UF was unchanged from baseline in the control group but increased significantly (P < 0.001) in the icodextrin group from 141.6 ± 75.4 to 505.8 ± 46.8 ml at week 1 and 540.2 ± 46.8 ml at week 2.

In the icodextrin group, the incidence of negative net UF was significantly lower (P < 0.0001) than in the control group. Findings were similar for UF efficiency ratio. Rash was reported significantly more often in the icodextrin group. This study showed that in high-average and high transporters, icodextrin is superior to 4.25% dextrose for long-dwell fluid and solute removal.

Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes "on behalf of the Icodextrin High Transporter Trial Group "

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
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Created: Mon, 06 Jul 2009, 21:26:41 EST by Maria Campbell on behalf of Faculty Of Health Sciences