Clinical experience with icodextrin in children: ultrafiltration profiles and metabolism

Icodextrin use in adults provides sustained ultrafiltration (UF) in long-te rm dwells. No information is available on UF and metabolism in children. In 11 children, a volume of 1,049+/-138 ml/m(2) of the study fluid (1.36% glu cose, 7.5% icodextrin, 3.86% glucose) was administered for 12 h. Net UF wit h icodextrin (339+/-147 ml/1.73 m(2)) did not differ from UF with 3.86% glu cose (450+/-306 ml/1.73 m(2), P=0.53) and was higher than UF with 1.36% glu cose (-87+/-239 ml/1.73 m(2), P=0.003). Icodextrin added 0.52+/-0.07 to the weekly Kt/V. Over 6 weeks, icodextrin was used for 12-h daytime dwell. Tot al icodextrin reached a steady-state level of 2.91+/-1.22 g/l at 2 weeks. T he main icodextrin metabolites were maltose, maltotriose, and maltotetraose . After 2 weeks, steady state levels were 2.02+/-0.66 mmol/l, 1.46+/-0.35 m mol/l, and 0.45+/-0.12 mmol/l. No icodextrin or metabolites were detectable 4 weeks after the study. We conclude that 7.5% icodextrin is capable of ma intaining UF during 12-h dwell in children and is comparable to UF obtained with 3.86% glucose. Steady-state levels of icodextrin and metabolites were reached at 2 weeks and disappeared after the study.