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Patients initiating peritoneal dialysis started on two icodextrin exchanges daily.

Kwabena T Awuah1, Nancy Gorban-Brennan2, Hima Bindu Yalamanchili1

  • 1Yale New Haven Hospital, New Haven, Connecticut, USA.

Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|December 19, 2013
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Summary

This study explored using daily icodextrin exchanges for peritoneal dialysis (PD) in patients with residual renal function (RRF). The regimen maintained adequate dialysis dose (Kt/Vurea) and showed good patient satisfaction with minimal adverse events.

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Peritoneal Dialysis

Background:

  • Standard peritoneal dialysis (PD) regimens are often applied uniformly, disregarding individual residual renal function (RRF) in end-stage renal disease (ESRD) patients.
  • Tailoring PD therapy to patient-specific RRF can optimize solute clearance and potentially preserve renal function.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of initiating PD with two daily icodextrin exchanges in patients with adequate RRF.
  • To assess the impact of this regimen on dialysis adequacy (Kt/Vurea) and patient tolerance.

Main Methods:

  • Patients with ESRD and RRF (weekly Kt/Vurea ≥ 1.0) were initiated on PD with two daily icodextrin exchanges.
  • Peritoneal and residual renal Kt/Vurea were monitored to ensure total Kt/Vurea was maintained between 1.7 and 2.0.
  • Adverse events and patient satisfaction were recorded.

Main Results:

  • The icodextrin regimen successfully maintained total Kt/Vurea within the target range of 1.7–2.0.
  • One patient experienced a rash, necessitating a switch to three daily dextrose exchanges.
  • All other patients tolerated the icodextrin regimen well, reporting satisfaction and no other adverse events.

Conclusions:

  • Initiating PD with two daily icodextrin exchanges is a viable and well-tolerated option for ESRD patients with sufficient RRF.
  • This tailored approach can achieve adequate dialysis dose while ensuring patient comfort and satisfaction.
  • Further research may explore long-term outcomes and broader applicability of icodextrin-based PD regimens.