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Effect of Icodextrin Solution on the Preservation of Residual Renal Function in Peritoneal Dialysis Patients A Randomized Controlled Study

Title
Effect of Icodextrin Solution on the Preservation of Residual Renal Function in Peritoneal Dialysis Patients A Randomized Controlled Study
Authors
Chang, Tae IkRyu, Dong-RyeolYoo, Tae-HyunKim, Hyung JongKang, Ea WhaKim, HyunwookChang, Jae HyunKim, Dong KiMoon, Sung JinYoon, Soo YoungHan, Seung HyeokYonsei Associate Network CHronic K
Ewha Authors
류동열
SCOPUS Author ID
류동열scopus
Issue Date
2016
Journal Title
MEDICINE
ISSN
0025-7974JCR Link1536-5964JCR Link
Citation
vol. 95, no. 13
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Although icodextrin solution has been highlighted in the fluid management compared to glucose-based solutions, proof of a beneficial effect of icodextrin solution on residual renal function (RRF) is lacking. We conducted a multicenter prospective randomized controlled open-label trial to investigate whether icodextrin solution can preserve RRF. One hundred patients with urine volume >= 750 mL/day from 8 centers in Korea were randomly assigned to receive 1 exchange of icodextrin solution for a >= 8 hour-dwell time and 2 exchanges of 1.5% glucose-based biocompatible neutral pH solution or 1 exchange of >= 2.5% and 2 exchanges of 1.5% glucose-based biocompatible solutions. Using mixed-effects general linear models, we analyzed changes in residual glomerular filtration rate (GFR) and daily urine volume at 1 year. Forty-nine patients were assigned to the icodextrin group and 51 to the glucose solution group. During follow-up, the slope of the decline in residual GFR was -0.170mL/min/month/1.73m(2) in the icodextrin group, while it was -0.155mL/min/month/1.73m(2) in the glucose solution group (95% confidence interval [CI], -0.06 to 0.10; P=0.701). Daily urine volume decreased faster in the glucose solution group than in the icodextrin group (-31.02 vs -11.88mL per month; 95% CI, -35.85 to -2.44; P=0.025). Results were consistent when we analyzed using intention-to-treat and per protocol principles. There were no differences in fluid status, peritoneal ultrafiltration, and peritoneal transport between groups during follow-up. This study clearly showed that icodextrin solution preserves residual urine volume better than glucose solution.
DOI
10.1097/MD.0000000000002991
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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