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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Icodextrin (Ico) is a key osmotic agent for managing fluid overload in peritoneal dialysis (PD) patients, which is expected to reduce heart failure risk. However, its association with overall cardiovascular (CV) risk remains controversial. Ico solutions contain 3.5 mEq/L of calcium, which may lead to a positive calcium balance if peritoneal convection is insufficient. We hypothesized that the use of Ico is associated with an increased risk of CV events, potentially mediated by an increased calcium load.
We retrospectively analyzed 156 incident PD patients from our center. We treated Ico exposure as a time-dependent variable, assessed every 6 months. The association between Ico use and the first CV event was evaluated using both a conventional Cox proportional hazards model and a Fine-Gray competing risk model. The Fine-Gray model accounted for competing events, including death, transfer to another facility, technical failure, and kidney transplantation. Models were adjusted for age, sex, diabetes, baseline BMI, and prior CV disease. A landmark analysis with a 6-month lag time was performed as a sensitivity analysis. Furthermore, the association between Ico use and serum corrected calcium levels was assessed using a linear mixed-effects model.
The median follow-up period was 22.0 (IQR: 7.3-38.4) months. During this period, 119 patients (76.3%) used Ico. A total of 46 patients developed a new CV event. Notably, a larger number of patients (n=53) experienced a competing event before developing CV events. In the conventional Cox model, Ico use was not significantly associated with CV events (HR 1.44, 95% CI: 0.68-3.05, p=0.34). However, the Fine-Gray model revealed a significant association between Ico use and a higher cumulative incidence of CV events (subdistribution HR [sHR] 2.91, 95% CI: 1.43-5.97, p=0.003). This tendency was consistent across all subgroups and in the 6-month lag time analysis. The linear mixed-effects model showed that Ico use was independently associated with higher serum corrected calcium levels (Coefficient 0.26, 95% CI: 0.17-0.35, p<0.001).
In our cohort of PD patients, Ico use was not associated with a reduced risk of CV events. The Fine-Gray model unmasked a significant association between Ico use and increased CV risk, which was obscured in the conventional Cox model due to a high rate of competing events. The observed association of Ico use with elevated serum calcium suggests that the potential calcium load may offset the benefits of ultrafiltration. This finding highlights a potential risk of Ico therapy and warrants further investigation.
