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Perit Dial Int 29(4): 443-449
2009
© 2009 International Society for Peritoneal Dialysis
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Icodextrin

EFFECTS OF TWICE-DAILY ICODEXTRIN ADMINISTRATION ON BLOOD PRESSURE AND LEFT VENTRICULAR MASS IN PATIENTS ON CONTINUOUS AMBULATORY PERITONEAL DIALYSIS

Tansu Sav1, Oktay Oymak2, Mehmet Tugrul Inanc3, Ali Dogan3, Bulent Tokgoz2 and Cengiz Utas2

Department of Nephrology,1 Government Hospital; Department of Nephrology 2 and Department of Cardiology,3 Erciyes University, Kayseri, Turkey

Correspondence to: T. Sav, Erciyes Universitesi Organ Nakli ve Diyaliz Hastanesi 38020 Talas, Kayseri, Turkey. savtansu{at}gmail.com; savtansu{at}hotmail.com

{diamondsuit} Background: Hypervolemia is a risk factor for left ventricular hypertrophy and hypertension in peritoneal dialysis patients. Icodextrin improves volume control by increasing ultrafiltration in peritoneal dialysis patients.

{diamondsuit} Aim: To examine the effects of twice-daily icodextrin administration on blood pressure and left ventricular hypertrophy in peritoneal dialysis patients with hypervolemia and ultrafiltration failure.

{diamondsuit} Method and Results: Administration of icodextrin twice daily resulted in a significant reduction in the left ventricular mass index (LVMI) of patients by the end of the third month (p < 0.05). The reduction in LVMI was also significant for the once-daily icodextrin group (p < 0.05). Mean blood pressure of patients receiving icodextrin twice daily was significantly reduced (p < 0.05). By the end of the third month no significant changes were observed in mean blood pressure of the patients using once-daily icodextrin (p > 0.05). No statistically significant changes were observed in weekly total creatinine clearances or Kt/V of patients in either group at the end of 3 months (NS).

{diamondsuit} Conclusion: Twice-daily icodextrin administration was clinically beneficial as shown by reduced blood pressure and prevention of the progress of left ventricular hypertrophy without causing any decrease in dialysis adequacy or any side effects. The icodextrin metabolite results did not suggest any further increase in their values when comparing once- to twice-daily administration of icodextrin. Although prescription of icodextrin once daily may yield good clinical results in the long term, this study showed that it may be more efficient to use twice-daily icodextrin for at least a specific period for the purpose of obtaining quicker results in patients with ultrafiltration failure, serious hypervolemia, or hard-to-control blood pressure conditions.

KEY WORDS: Icodextrin; ultrafiltration failure; hypertension; left ventricular hypertrophy; icodextrin metabolites.

Received 13 November 2008; accepted 8 April 2009.




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P. G. Blake
NOVEL APPROACHES TO PRESCRIBING ICODEXTRIN
Perit. Dial. Int., July 1, 2009; 29(4): 412 - 414.
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