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Perit Dial Int 26(3): 336-340 2006
© 2006 International Society for Peritoneal Dialysis
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Clinical

WHAT IS THE OPTIMAL DWELL TIME FOR MAXIMIZING ULTRAFILTRATION WITH ICODEXTRIN EXCHANGE IN AUTOMATED PERITONEAL DIALYSIS PATIENTS?

Tarun K. Jeloka1, Fevzi F. Ersoy2, Mahmut Yavuz3, Krishna M. Sahu1, Taner Çamsari4, Cengiz Utas5, Semra Bozfakioglu6, Çetin Özener7, Kenan Ates8, Rezzan Ataman9, Fehmi Akçiçek10, Tekin Akpolat11, Ibrahim Karayaylali12, Turgay Arinsoy13, Emin Yilmaz Mehmet14, Gültekin Süleymanlar2, Dorothy Burdzy1 and Dimitrios G. Oreopoulos1

University of Toronto,1 Canada; Akdeniz University,2 Antalya; Uludag University,3 Bursa; Dokuz Eylül University,4 Izmir; Erciyes University,5 Kayseri; Çapa Medical School,6 Istanbul University; Marmara University,7 Istanbul; Ankara University,8 Ankara; Cerrahpasa Medical School,9 Istanbul University, Istanbul; Ege University,10 Izmir; Ondokuz Mayis University,11 Samsun; Çukurova University,12 Adana; Gazi University,13 Ankara; Dicle University,14 Diyarbakir, Turkey

Correspondence to: D.G. Oreopoulos, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8 Canada.dgo{at}teleglobal.ca

{diamondsuit} Background: Icodextrin is increasingly being used in automated peritoneal dialysis (APD) for the long dwell exchange to maintain adequate ultrafiltration (UF). However, the UF reported in the literature varies with different dwell times: from 200 to 500 mL with 12 - 15 hour dwells. In order to maximize UF, it is important to know the relationship between dwell time and UF when using icodextrin in APD patients. With this knowledge, decisions can be made with respect to dwell period, and adjustments to the dialysis prescription can be made accordingly.

{diamondsuit} Methods: We prospectively studied this relationship in 36 patients from Canada and Turkey. All patients did the icodextrin day exchange manually after disconnecting themselves from overnight cycler dialysis. Dwell period was increased by 1 hour every week, from 10 to 14 hours. Ultrafiltration was noted for each icodextrin exchange. Mean UF for each week (i.e., dwell period) was compared by repeated measures ANOVA.

{diamondsuit} Results: We found no difference in mean UF with increasing dwell time: 351.73 ± 250.59 mL at 10 hours versus 371.75 ± 258.25 mL at 14 hours (p = 0.83). We also compared mean UF between different subgroups and found that males (p = 0.02 vs females) and high transporters (p = 0.04 vs low) had higher mean UF. Further analysis of maximal UF showed no correlation to age, sex, diabetic status, transport category, creatinine clearance, Kt/V, duration on peritoneal dialysis, or duration of icodextrin use.

{diamondsuit} Conclusion: Icodextrin-related UF in APD patients is not related to demographic factors and does not increase significantly beyond 10 hours.

KEY WORDS: Icodextrin; ultrafiltration; automated peritoneal dialysis.

Received 20 July 2005; accepted 3 October 2005.






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