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Claus Peter Schmitt, Christoph Aufricht
Introduction of the so-called biocompatible peritoneal dialysis (PD) fluids was based on a large body of experimental evidence and various clinical trials suggesting important clinical benefits. Of these, until now, only preservation of residual renal function-likely due to lower glucose degradation product load and, in case of icodextrin, improved fluid and blood pressure control-have consistently been proven, whereas the impact on important clinical endpoints such as infectious complications, preservation of PD membrane transport function, and patient outcome, are still debated...
October 8, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Sofia Rubinstein, Rafael Franjul, Sikander Surana, Joshua Fogel
The 7.5% icodextrin solution is widely used for long-dwell in peritoneal dialysis (PD) regimens as an alternative osmotic agent to glucose. It has been defined as a biocompatible agent because of its iso-osmolarity and is generally safe and well tolerated. Icodextrin and its hydrolyzed metabolites are found in systemic circulation. In serum, icodextrin interferes with amylase determination causing a significantly decreased plasma amylase level making it unreliable for the diagnosis of acute pancreatitis. Lipase measurement provides an alternative and accurate method for diagnosing acute pancreatitis (AP) in patients using icodextrin...
November 2016: Clinical Nephrology
Turker Karanci, Bilal Kelten, Alper Karaoglan, Nilgun Cinar, Ahmet Midi, Veysel Antar, Hidayet Akdemir, Zeynep Mine Kara
AIM: The aim of this experimental study is to investigate whether spinal epidural 4% glucose polymer solution is effective in the prevention of fibrosis with postoperative. MATERIAL AND METHODS: Twenty eight adult Wistar albino rats were randomly divided into two equal groups, including treatment and control. Both groups underwent L1 vertebral total laminectomy to expose the dura. Topical treatment group received % 4 icodextrin. Four weeks later, epidural fibrosis was examined in both groups histologically, biochemically and macroscopically...
September 14, 2015: Turkish Neurosurgery
Naoya Yamaguchi, Keiichi Miyamoto, Tomohiro Murata, Eiji Ishikawa, Takashi Horiuchi
A two-compartment system (NICOPELIQ; NICO, Terumo Co., Tokyo, Japan) has recently been developed to neutralize icodextrin peritoneal dialysis fluid (PDF). In this study, a nonclinical evaluation of NICO was carried out to evaluate biocompatibility as well as water transport ability. Glucose degradation products (GDPs) in the icodextrin PDFs were analyzed via high-performance liquid chromatography (HPLC). The cell viability of human peritoneal mesothelial cells derived from peritoneal dialysis effluent (PDE-HPMCs) was evaluated as well as the amount of lactate dehydrogenase (LDH) released after exposure to different PDFs (NICO and EXTRANEAL [EX, Baxter Healthcare Corp...
August 2016: Artificial Organs
Joana Sampaio, Diana Machado, Ana Marta Gomes, Idalina Machado, Cledir Santos, Nelson Lima, Maria João Carvalho, António Cabrita, Anabela Rodrigues, Margarida Martins
Infections are major complications in peritoneal dialysis (PD) with a multifactorial etiology that comprises patient, microbial and dialytic factors. This study aimed at investigating the contribution of microbial biofilms on PD catheters to recalcitrant infections and their interplay with PD related-factors. A prospective observational study was performed on 47 patients attending Centro Hospitalar of Porto and Vila Nova de Gaia/Espinho to whom the catheter was removed due to infectious (n = 16) and non-infectious causes (n = 31)...
2016: PloS One
Tabo Sikaneta, George Wu, Mohamed Abdolell, Anita Ng, Sara Mahdavi, Anton Svendrovski, Tony Tu, Trish Mercer, Matthew Tong, Dimitrios Oreopoulos, Paul Tam
UNLABELLED:BACKGROUND AND OBJECTIVE: Residual renal function (RRF) correlates with mortality and morbidity rates in patients receiving peritoneal dialysis (PD). We examined the effect of a biocompatible PD solution (Gambrosol Trio; Gambro Lundia AB, Lund, Sweden) with lower concentrations of glucose degradation products on rates of decline in RRF. ♦ DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Incident patients at 2 centers in Canada and 1 in Hong Kong were randomized (by minimization) in an open-label parallel group trial to receive Gambrosol Trio or standard PD solution (Dianeal; Baxter Healthcare, Mississauga, Canada) for 2 years...
September 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Sharon Rousso, Tonny M Banh, Susan Ackerman, Elizabeth Piva, Christoph Licht, Elizabeth A Harvey
BACKGROUND: Icodextrin is a solution of glucose polymers developed to provide sustained ultrafiltration over an extended dwell. Our aim was to determine whether or not fill volume with icodextrin contributes to the ability to achieve ultrafiltration in children. METHODS: The charts of all children on chronic peritoneal dialysis between January 2000 and July 2014 were screened for the use of an icodextrin day dwell. Data were extracted from the electronic chart and the HomeChoice™ Pro card and corrected for body surface area (BSA)...
October 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Guillaume Deslandes, Matthieu Gregoire, Régis Bouquié, Aude Le Marec, Sophie Allard, Eric Dailly, Alain Pineau, Emma Allain-Launay, Pascale Jolliet, Gwenaëlle Roussey, Dominique Navas
♦ Objectives: Assess the stability of several antibiotics in peritoneal dialysis (PD) solutions under common conditions of use in pediatrics, particularly in automated PD. ♦ Methods: Amoxicillin, cefazolin, cefepime, ceftazidime, imipenem, cotrimoxazole, tobramycin, vancomycin, and the association of ceftazidime + vancomycin and ceftazidime+ tobramycin, were tested in 3 different PD solutions: bicarbonate/lactate solution with 2 glucose concentrations (Physioneal 1.36 and 3.86%; Baxter Healthcare Corporation, Deerfield, IL, USA) and an icodextrin-containing solution (Extraneal; Baxter Healthcare Corporation, Deerfield, IL, USA)...
May 4, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
I-Kuan Wang, Chi-Yu Lu, Chih-Hsin Muo, Chiz-Tzung Chang, Tzung-Hai Yen, Chiu-Ching Huang, Tsai-Chung Li, Fung-Chang Sung
PURPOSE: This study used national claims data to investigate the technique and patient survival over time in incident peritoneal dialysis (PD) patients. METHODS: Incident end-stage renal disease patients undergoing PD and older than 18 years were selected from Taiwan health insurance databases. These patients were grouped into three study periods according to year of dialysis initiation: 1997-2001, 2002-2006, and 2007-2011. The study end-points included technique failure and mortality...
July 2016: International Urology and Nephrology
Tae Ik Chang, Dong-Ryeol Ryu, Tae-Hyun Yoo, Hyung Jong Kim, Ea Wha Kang, Hyunwook Kim, Jae Hyun Chang, Dong Ki Kim, Sung Jin Moon, Soo Young Yoon, Seung Hyeok Han
Although icodextrin solution has been highlighted in the fluid management compared to glucose-based solutions, proof of a beneficial effect of icodextrin solution on residual renal function (RRF) is lacking. We conducted a multicenter prospective randomized controlled open-label trial to investigate whether icodextrin solution can preserve RRF.One hundred patients with urine volume ≥750 mL/day from 8 centers in Korea were randomly assigned to receive 1 exchange of icodextrin solution for a ≥8 hour-dwell time and 2 exchanges of 1...
March 2016: Medicine (Baltimore)
Dominik Steubl, Marcel Roos, Stefan Hettwer, Susanne Angermann, Ming Wen, Christoph Schmaderer, Peter Luppa, Uwe Heemann, Lutz Renders
BACKGROUND/AIMS: This study compares the peritoneal elimination of the low-molecular-weight-protein (LMWP) C-terminal agrin fragment (tCAF, size 22 kDa), a promising biomarker for kidney function, in continuous cycling peritoneal dialysis (CCPD) and continuous ambulatory peritoneal dialysis (CAPD). METHODS: 103 sets of serum, 24h-urine and dialysate samples were obtained in 15 CCPD (63 sets) and 11 CAPD (40 sets) patients. Total, renal and peritoneal substrate removals/clearances were measured/calculated for tCAF, creatinine, blood-urea-nitrogen (BUN), cystatin C and albumin and correlated with the peritoneal transport type...
2016: Kidney & Blood Pressure Research
T Sakari, R Sjödahl, L Påhlman, U Karlbom
AIM: Adhesions are the most common cause of small bowel obstruction (SBO). The costs of hospitalization and surgery for SBO are substantial for the health-care system. The adhesion-limiting potential of icodextrin has been shown in patients undergoing surgery for gynaecological diseases. A randomized, multicentre trial in colorectal cancer surgery started in 2009 with the aim of evaluating whether icodextrin could reduce the long-term risk of surgery for SBO. Because of some concerns about complications (especially anastomotic leakage) after icodextrin use, a preplanned interim analysis of morbidity and mortality was conducted...
March 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Sylvie Opatrná, Anna Pöpperlová, Daniel Lysák, Radka Fuchsová, Ladislav Trefil, Jaroslav Racek, Ondrej Topolčan
Icodextrin peritoneal dialysis (PD) solution has been shown to increase interleukin-6 (IL-6) levels in PD effluent as well as leukocyte and mesothelial cell count. Mesothelial cells release cancer antigen 125 (CA125), which is used as a marker of mesothelial cell mass. This 1-year prospective study was designed to compare peritoneal effluent cell population, its inflammatory phenotype and biocompatibility biomarkers IL-6 and CA125 between icodextrin (E) and glucose bicarbonate/lactate (P) based PD solutions...
April 2016: Therapeutic Apheresis and Dialysis
Anne B Taegtmeyer, Nina Kononowa, Dominique Fasel, Manuel Haschke, Felix Burkhalter
We investigated the pharmacokinetics of intraperitoneal administration of daptomcyin in a peritoneal dialysis (PD) patient treated for a pacemaker infection with Staphylococcus epidermidis. After initial start of intravenous daptomycin at 9 mg/kg body weight every 48 hours, the therapy was switched to intraperitoneal administration of 5.3 mg/kg body weight in 1 L icodextrin 7.5% with a dwell time of 12 hours overnight every 48 hours. Therapeutic drug monitoring (TDM) was performed at 4 hours and 24 hours after dose administration...
January 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Annie-Claire Nadeau-Fredette, David W Johnson, Carmel M Hawley, Elaine M Pascoe, Yeoungjee Cho, Philip A Clayton, Monique Borlace, Sunil V Badve, Kamal Sud, Neil Boudville, Stephen P McDonald
UNLABELLED:BACKGROUND: Previous studies have reported significant variation in peritonitis rates across dialysis centers. Limited evidence is available to explain this variability. The aim of this study was to assess center-level predictors of peritonitis and their relationship with peritonitis rate variations. ♦ METHODS: All incident peritoneal dialysis (PD) patients treated in Australia between October 2003 and December 2013 were included...
September 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Stanley Fan, Andrew Davenport
PURPOSE: Loss of residual renal function (RRF) is associated with an increased risk for peritoneal dialysis (PD) technique failure and patient death. We wished to determine which factors were associated with PD technique failure and patient mortality once urine output had fallen to <100 mL/day. METHODS: We followed 183 PD patients who lost RRF and who had measurements taken at that time of PD small solute clearances, ultrafiltration volume, PD transport status and multiple frequency bioelectrical impedance assessments (MFBIA) of extracellular water (ECW)...
November 2015: International Journal of Artificial Organs
Sabrina Gensberger-Reigl, Jochen Huppert, Monika Pischetsrieder
During heat sterilization of peritoneal dialysis (PD) fluids, the glucose component is partially degraded. The formed glucose degradation products impair biocompatibility and limit the long-term application of PD fluids. As an alternative to glucose, icodextrin, a polyglucose, is used as osmotic agent in PD fluids. After targeted screening for reactive carbonyl compounds, NMR- and MS-analyses very recently revealed 4-deoxyglucosone (4-DG), 3-deoxyglucosone (3-DG), 3-deoxygalactosone (3-DGal), 3,4-dideoxypentosone (3,4-DDPS), and 5-hydroxymethylfurfural (5-HMF) as main polyglucose degradation products (pGDPs) in icodextrin-based PD fluids...
January 25, 2016: Journal of Pharmaceutical and Biomedical Analysis
Robiyanto Robiyanto, Syed Tabish R Zaidi, Madhur D Shastri, Ronald L Castelino, S Troy Wanandy, Matthew D Jose, Rahul P Patel
UNLABELLED:INTRODUCTION: Intraperitoneal tigecycline is a potential option for the treatment of peritoneal dialysis (PD)-associated peritonitis caused by microorganisms resistant to commonly used antibiotics. However, the stability of tigecycline must be assessed in the PD solution before evaluating its safety and therapeutic efficacy in PD-associated peritonitis. The objective of this study was to investigate the stability of tigecycline in 3 types of PD solutions at different temperatures for various time points...
July 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Kübra Dogan, Damla Kayalp, Gözde Ceylan, Alper Azak, Mehmet Senes, Murat Duranay, Dogan Yucel
BACKGROUND: Peritoneal dialysis (PD) is used as an alternative to hemodialysis in end-stage renal disease (ESRD). Icodextrin has been used as a hyperosmotic agent in PD. The aim of the study was to assess two different point-of-care testing (POCT) glucose strips, affected and not affected by icodextrin, with serum glucose concentrations of the patients using and not using icodextrin. METHODS: Fifty-two chronic ambulatory peritoneal dialysis (CAPD) patients using icodextrin (Extraneal®) and 20 CAPD patients using another hyperosmotic fluid (Dianeal®) were included in the study...
September 2016: Journal of Clinical Laboratory Analysis
Dwarakanathan Ranganathan, Saiyuri Naicker, Steven C Wallis, Jeffrey Lipman, Sharad K Ratanjee, Jason A Roberts
UNLABELLED:BACKGROUND AND OBJECTIVES: Patients with peritoneal dialysis (PD)-associated peritonitis may be advised to store PD-bags with pre-mixed antibiotics at home, although there is a paucity of antibiotic stability studies in the commonly used icodextrin solutions. The purpose of this study was to assess the stability of various antibiotics in PD-bags when stored at different temperatures over a 14-day period. ♦ METHODS: 7.5% icodextrin PD-bags were dosed with gentamicin 20 mg/L (n = 9), vancomycin 1,000 mg/L (n = 9), cefazolin 500 mg/L (n = 9) and ceftazidime 500 mg/L (n = 9) as for intermittent dosing...
July 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
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