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Perit Dial Int 27(3): 267-276 2007
© 2007 International Society for Peritoneal Dialysis
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Clinical

COMBINATION OF CRYSTALLOID (GLUCOSE) AND COLLOID (ICODEXTRIN) OSMOTIC AGENTS MARKEDLY ENHANCES PERITONEAL FLUID AND SOLUTE TRANSPORT DURING THE LONG PD DWELL

Philippe Freida1, Magda Galach2, Jose C. Divino Filho3, Andrzej Werynski2 and Bengt Lindholm3

1 Department of Nephrology, Louis Pasteur District Hospital, Cherbourg, France;2 Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Science, Warsaw, Poland;3 Divisions of Baxter Novum and Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden

Correspondence to: P. Freida, Service de Nephrologie, Centre Hospitalier Louis Pasteur, Cherbourg, 50102 France.
p.freida{at}ch-cherbourg.fr

{diamondsuit} Background: Fluid and sodium removal is often inadequate in peritoneal dialysis patients with high peritoneal solute transport rate, especially when residual renal function is declining.

{diamondsuit} Method: We studied the effects of using simultaneous crystalloid (glucose) and colloid (icodextrin) osmotic agents on the peritoneal transport of fluid, sodium, and other solutes during 15-hour single-dwell exchanges using 3.86% glucose, 7.5% icodextrin, and a combination fluid with 2.61% glucose and 6.8% icodextrin in 7 prevalent peritoneal dialysis patients with fast peritoneal solute transport rate.

{diamondsuit} Results: The combination fluid enhanced net ultrafiltration (mean 990 mL) and sodium removal (mean 158 mmol) compared with 7.5% icodextrin (mean net ultrafiltration 462 mL, mean net sodium removal 49 mmol). In contrast, the 3.86% glucose-based solution yielded negligible ultrafiltration (mean -85 mL) and sodium removal (mean 16 mmol). The combination solution resulted in significantly improved urea (+41%) and creatinine (+26%) clearances compared with 7.5% icodextrin.

{diamondsuit} Conclusion: A solution containing both crystalloid (glucose 2.61%) and colloid (icodextrin 6.8%) osmotic agents enhanced fluid removal by twofold and sodium removal by threefold compared with 7.5% icodextrin solution during a dwell of 15 hours, indicating that such a combination solution could represent a new treatment option for anuric peritoneal dialysis patients with high peritoneal solute transport rate.

KEY WORDS: KEY WORDS:; Ultrafiltration; icodextrin; glucose; sodium.

Received 16 October 2006; accepted 14 December 2006.




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Future technologies and techniques in peritoneal dialysis--opportunities and challenges ahead
NDT Plus, October 1, 2008; 1(suppl_4): iv51 - iv55.
[Abstract] [Full Text] [PDF]


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