Comparison of clinical outcomes based on dialysis modality and icodextrin usage in patients on peritoneal dialysis

There is no conclusive evidence regarding the survival benefits of automated peritoneal dialysis (APD) or the use of icodextrin. This study aimed to evaluate patient and technique survival among four groups divided based on peritoneal dialysis modality and icodextrin use over 1 year.

We specifically included patients who underwent a single peritoneal dialysis modality for at least 1 year during that period (n = 148). The participants were categorized into four groups for comparison: continuous ambulatory peritoneal dialysis (CAPD) without icodextrin (CAPD-ET, n = 39); CAPD with icodextrin (CAPD+ET, n = 35); APD without icodextrin (APD-ET, n = 40); and APD with icodextrin (APD+ET, n = 34).

The CAPD+ET group had a higher patient survival rate than that of the APD-ET group and also had a higher technique survival trend than that of the APD-ET group, despite no statistical significance. In patients without diabetes mellitus (DM), the APD-ET group had a poorer patient survival trend than those of the APD+ET or CAPD+ET groups. In patients without DM, the APD+ET group had a higher technique survival than the APD-ET group. In addition, the APD+ET group showed a higher technique survival trend than did the CAPD-ET group, despite non-statistical significance. The edema index after 1 year of follow-up was higher in the APD-ET group than in the other groups.

The present study demonstrated that patients undergoing APD without icodextrin had poor patient and technique survival trends, which may be caused by poor volume control.