Long daytime exchange in children on continuous cycling peritoneal dialysis: preservation of drained volume because of icodextrin use.
Adv Perit Dial
; 21: 195-9, 2005.
Article
in En
| MEDLINE
| ID: mdl-16686317
ABSTRACT
Daytime exchanges with glucose osmotic agents often lead to dialysate reabsorption, poor ultrafiltration (UF), positive sodium balance, and restricted purification of uremic toxins. We studied 5 anuric children on continuous cycling peritoneal dialysis (mean age 10 years, 10 months), comparing icodextrin to a conventional glucose-based dialysate. The same fill volume (980 +/- 290 mL/m2) and the same dwell duration (720 minutes) were used with both solutions for the daytime exchange. In a crossover design, we compared 7.5% icodextrin with 1.36% glucose, and then 1.36% glucose with 7.5% icodextrin. Tolerance, net UF, sodium balance, and solute extraction were analyzed. The Student t-test for paired data was used for statistical analysis. The drained volume was 44% +/- 18% higher during icodextrin exchanges, allowing a mean enhanced sodium extraction of 44 +/- 15 mmol per daytime exchange. The uremic toxin extraction capacity was enhanced under icodextrin weekly Kt/V urea increased by 0.41 +/- 0.1, weekly creatinine clearance increased by 8.4 +/- 3.6 L/1.73 m2, and phosphate removal increased by 23%. Similarly, beta2-microglobulin extraction increased with icodextrin use. Dialysate protein loss under icodextrin increased from 1.3 +/- 0.6 g to 1.9 +/- 0.96 g per daytime exchange. Icodextrin improved ultrafiltration and purification capacities (urea, creatinine, phosphate, beta2-microglobulin), but the large drained volume directly affected dialysate protein loss.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hemodialysis Solutions
/
Peritoneal Dialysis
/
Glucans
/
Glucose
Limits:
Adolescent
/
Adult
/
Child
/
Child, preschool
/
Humans
Language:
En
Journal:
Adv Perit Dial
Journal subject:
NEFROLOGIA
Year:
2005
Document type:
Article
Affiliation country: