OUTCOMES OF CAPD PATIENTS BETWEEN ICODEXTRIN AND NON-ICODEXTRIN PERITONEAL DIALYSIS FLUID USAGES

Introduction:

Continuous Ambulatory peritoneal dialysis (CAPD) is a well-established mode of renal replacement therapy in India. Icodextrin which is iso-osmolar, lower glucose degradation end products PD fluid has found to have positive metabolic outcomes along with reduction of peritonitis in some studies. This study was done to compare the different outcomes between patients treated with icodextrin and glucose containing PD fluid.

Methods:

It was a hospital based retrospective study in patients who received CAPD for at least 90 days between January 2020 and December 2023 at Sanjay Gandhi Postgraduate Institute of Medical Sciences, India. Patient’s PD fluids were divided as two groups as glucose containing fluid only or glucose fluid and added icodextrin and then, different outcomes like technique failure, technique survival, ultrafiltration failure, peritonitis rate and mortality rate were measured between patients with these two PD fluid groups.  

Results:

After analysis of total 122 CAPD patients, almost 70% of study population was male and mean age was 41.56 ± 21.5 along with the youngest, 4 years and the oldest, 88 years respectively. Patients with icodextrin group was significantly higher age than non icodextrin group (p=0.004). Majority of the patients have hypertension about 76% and icodextrin used group was significantly higher BP than non- icodextrin group (p= 0.001). Diabetes was present in 36% of CAPD patients and which was not different among groups. Patients with icodextrin have significantly lower mean total cholesterol and triglyceride level with 157.7 mg/dl and 148 mg/dl respectively than non-icodextrin used with 204.9 mg/dl and 237.2 mg/dl respectively. Moreover, mean HbA1C level was also significantly lower in icodextrin group than non icodextrin group with 6.36 % and 7.17% respectively. Even better metabolic control in icodextrin group, these factors were not associated with better overall PD outcomes.  Other variables were found not significantly between two groups.  Regarding peritonitis, overall peritonitis rate was almost 30% during study period in both sites and there was no different of peritonitis rate and technique failure between two groups. Detail can be seen in table 1.

Conclusions:

  CAPD patients using icodextrin have significant better metabolic control compared to non icodextrin users however overall outcomes of technique survival, patient’s survival, peritonitis rate and technique failure were not much different between two groups. Therefore we might need specific icodextrin alone users and long term follow up study in future.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.