Enhanced Ultrafiltration using 7.5% Icodextrin / 1.36% Glucose Combination Dialysate: A Pilot Study

Abstract

ObjectiveA pilot study to compare the use of a combination dialysate (7.5% icodextrin / 1.36% glucose) versus icodextrin 7.5% alone for the long dwell in patients on peritoneal dialysis (PD).DesignA 4-week, prospective, randomized crossover study.SettingA large regional renal unit providing treatment for a population of 1.7 million.PatientsFive patients on continuous ambulatory PD (CAPD) and 3 patients on automated PD.Main Outcome MeasurementsLong-dwell and 24-hour ultrafiltration volumes, body weight, 24-hour ambulatory blood pressure, and antihypertensive / diuretic tablet count.ResultsThe use of the combination dialysate resulted in an increase in the median (interquartile range) long-dwell ultrafiltration, from 750 (650 – 828) mL to 1000 (889 – 1100) mL ( p < 0.001), and 24-hour ultrafiltration, from 739 (400 – 1623) mL to 956 (700 – 1750) mL ( p < 0.001). Weight, blood pressure, and tablet count remained unchanged.ConclusionsThe use of the novel combination dialysate resulted in a 33% increase in long-dwell ultrafiltration and a 29% increase in 24-hour ultrafiltration.