Effect of Dialysis Solution with Icodextrine o n the Ultrafiltration and SelectedMetabolic Parameters in Patients Treated by Peritoneal Dialysis

Overview

Background.
To date, peritoneal dialysis has been performed almost exclusively using dialysis solutionscontaining glucose as the osmotic agent. Use of these solutions is fraught with problems regarding adequate fluidremoval from the body and is also associated with undesirable metabolic effects; hence the search for alternativeosmotic agents. A dialysis solution with the glucose polymer icodextrin generates ultrafiltration on the principle ofcolloidal osmosis. The aim of the study was to establish the effect of icodextrin-base dialysis solution on the magnitudeof ultrafiltration and evaluate selected metabolic parameters of patients treated by ambulatory peritoneal dialysis.Methods and Results. A total of 9 patients whose glucose-based solution was replaced by an icodextrin-basedsolution during the night-time exchange were evaluated. A control group of 9 patients used glucose-solution duringall exchanges. Night-time bag ultrafiltration, blood pressure, and the serum levels of lipids, insulin, leptin, maltose,and amylase were determined before icodextrin administration (time 0), at one-month intervals (time 1, 2, 3), andone month after study completion (time 4). In icodextrin-treated patients, ultrafiltration rose from 246.5±60.5 ml(mean ± SEM) at time 0 to 593.1±87.4 ml; p

Key words:
peritoneal dialysis, ultrafiltration, hydratation, icodextrin, osmotic agent, ma ltose, leptin, amylase,insulin.