ICODEXTRIN USE IN CCPD PATIENTS DURING PERITONITIS - ULTRAFILTRATION AND SERUM DISACCHARIDE CONCENTRATIONS

Background and methods. In a randomized study on the biocompatibility of icodextrin (I) versus glucose (G) in CCPD we used icodextrin or glu cose for the long daytime dwell. During the night-time dwells glucose was used in all patients. In case of peritonitis icodextrin was contin ued. In all patients ultrafiltration (UF) was recorded and serum icode xtrin metabolites were determined every 3 months and during peritoniti s in I-users when available. Results, Thirty-eight patients (19 G, 19 I) entered the study and suffered 30 peritonitis episodes (16 G, 14 I) . During peritonitis (P), daytime dwell UF decreased significantly in G (P=0.001), but remained stable in I patients compared to non-periton itis (NP) episodes. Total 24-h UF decreased in G (P=0.001) and in I pa tients (P = 0.04), as the result of a decreased daytime UF and night-t ime UF, respectively. There was no difference in the used glucose conc entrations during the P versus NP episodes. In five I-patients serum d isaccharides increased from 0.05 +/- 0.01 to 1.26 +/- 0.23 mg/ml durin g follow up. During peritonitis serum disaccharide concentrations did not increase further (1.47 +/- 0.24 mg/ml, P = 0.56). In I patients to tal carbohydrate minus glucose rose to 5.72 +/- 1.2 mg/ml during follo w up, and to 6.63 +/- 1.04 mg/ml during peritonitis (P = 0.7). These c oncentrations are comparable to CAPD patients despite the longer dwell time in CCPD (8-10 versus 14-16 h, respectively). Adverse reactions at tributable to icodextrin were not encountered. Conclusions. In contras t to glucose, icodextrin preserved the daytime dwell ultrafiltration d uring peritonitis. Serum icodextrin metabolites increased during icode xtrin use, but remained stable during peritonitis. Adverse effects wer e not observed.