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Practical considerations when prescribing icodextrin: a narrative review.

Samuel A Silver¹, Ziv Harel, Jeffrey Perl

¹Division of Nephrology, St. Michael's Hospital, University of Toronto, Toronto, Ont., Canada.

American Journal of Nephrology

|June 14, 2014

Summary

This summary is machine-generated.

Icodextrin, a peritoneal dialysis solution, offers glucose-sparing benefits but requires careful management. Understanding its hemodynamic, metabolic, and idiopathic effects is crucial to prevent adverse events in patients undergoing peritoneal dialysis.

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Area of Science:

Nephrology
Biochemistry

Background:

Icodextrin is a widely used peritoneal dialysis solution for enhanced ultrafiltration and preserving peritoneal membrane function.
Its glucose-sparing property is a key clinical advantage over dextrose-based solutions.
Healthcare providers need to be aware of icodextrin's unique properties due to its increasing clinical use.

Purpose of the Study:

To review the hemodynamic, metabolic, and idiopathic effects of icodextrin.
To provide guidance for the safe and effective prescription of icodextrin in peritoneal dialysis.
To minimize potential adverse events associated with icodextrin use.

Main Methods:

This study is a narrative review of existing literature on icodextrin.
It synthesizes information regarding the clinical considerations and effects of icodextrin.
The review focuses on adverse events and best practices for its application.

Main Results:

Hemodynamic effects can include hypotension due to increased ultrafiltration, potentially impacting residual kidney function.
Metabolic effects involve interference with biochemical assays, leading to inaccurate glucose readings on non-specific glucometers.
Idiopathic adverse effects encompass diffuse rash and sterile peritonitis; antibiotic stability in icodextrin also requires consideration.

Conclusions:

Failure to recognize icodextrin's specific properties can lead to patient harm.
Understanding these effects is essential for healthcare providers to confidently prescribe icodextrin.
Optimizing icodextrin use maximizes its benefits for patients on peritoneal dialysis.