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  1. Comparison of Icodextrin and Glucose Solutions for Long Dwell Exchange in Peritoneal Dialysis: A Meta-analysis of Randomized Controlled Trials

  2. Comparison of Icodextrin and Glucose Solutions for Long Dwell Exchange in Peritoneal Dialysis: A Meta-analysis of Randomized Controlled Trials Source Qi H, Xu C, Yan H, et al. Comparison of icodextrin and glucose solutions for long dwell exchange in peritoneal dialysis: a meta-analysis of randomized controlled trials. Perit Dial Int. 2010;31:179–188.

  3. Background Though glucose is used as the main osmotic agent in peritoneal dialysis (PD), it has various limitations such as reduced/loss of ultrafiltration (UF), and metabolic complications. Hence, there is a need for a more physiological solution containing an osmotic agent that would provide sustained UF and minimize metabolic complications. Icodextrin, a glucose polymer, has many advantages, including its ability to provide a sustained, positive net UF for at least 16 h, making it particularly useful for the long dwell exchange. Though, icodextrin is widely used in peritoneal dialysis, its the safety and efficacy are unclear.

  4. Aim To address the efficacy and safety of 7.5% icodextrin PD solution for the long dwell exchange in PD patients and to establish indications for icodextrin.

  5. Methods

  6. Key results • A greater net ultrafiltration was observed in patients using icodextrin. • The incidence of negative net UF was lower in patients using icodextrin compared to patients using 1.5%, 2.5%, and 4.25% glucose solutions. • Icodextrin has a markedly increased UF efficiency ratio (Fig. 1). • Compared to the glucose group, peritoneal clearances of creatinine and urea nitrogen were increased significantly in the icodextrin group. • No significant differences were observed between icodextrin and glucose groups with respect to residual renal function, risk of mortality, peritonitis, and total adverse events.

  7. Conclusion This meta-analysis suggests that icodextrin provides patients with greater fluid removal and small solute clearance and does not cause any damage to residual renal function. Icodextrin is particularly appropriate for use in patients with high peritoneal transport status.