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Sex Modulates Cardiovascular Effects of Icodextrin-Based Peritoneal Dialysis Solutions
Ramón Paniagua1, Elvia García-López2, Marcela Ávila-Díaz1
1Centro Médico Nacional Siglo XXI, Unidad de Investigación Médica en Enfermedades Nefrológicas, Hospital de Especialidades, Instituto Mexicano del Seguro Social, México, Mexico.
Frontiers in Physiology
|June 9, 2022
Summary
Female peritoneal dialysis patients accumulate higher icodextrin metabolites, potentially increasing blood volume and blood pressure due to sex-based differences in metabolism. Further research is needed.
Area of Science:
- Nephrology
- Endocrinology
- Biochemistry
Background:
- Icodextrin solutions in peritoneal dialysis (PD) may influence blood pressure (BP) and NT-proBNP levels.
- Accumulation of icodextrin metabolites might cause a colloid osmotic effect, increasing BP.
- Sex-based differences in alpha-Amylase gene copies suggest potential sex-specific icodextrin metabolism and cardiovascular effects.
Purpose of the Study:
- To investigate if icodextrin metabolite concentrations and cardiovascular effects differ between sexes in diabetic PD patients.
- To explore the influence of sex on fluid balance and blood pressure in patients using icodextrin or glucose PD solutions.
Main Methods:
- Secondary analysis of a randomized controlled trial (RCT) involving diabetic PD patients.
- Comparison of icodextrin versus glucose PD solutions.
- Measurement of serum icodextrin metabolites, osmolality, body composition, and Inferior Vena Cava (IVC) diameter at baseline, 6, and 12 months.
Main Results:
- Females exhibited higher serum icodextrin metabolite levels (G5-7, >G7) and lower serum osmolality after six months.
- Despite reduced body water, females had lower ultrafiltration (UF) volumes.
- Females showed increased IVC diameter and BP, indicating a potential increase in blood volume.
Conclusions:
- Female PD patients may experience higher icodextrin metabolite accumulation, leading to increased colloid-osmotic pressure.
- This could result in reduced UF volumes, increased blood volume, and elevated blood pressure in females.
- The role of lower alpha-Amylase gene copies in diabetic females warrants further investigation regarding these cardiovascular effects.
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