Icodextrin reduces the risk of congestive heart failure in peritoneal dialysis patients.

PURPOSE: Icodextrin can enhance ultrafiltration and consequently improve fluid balance and can control blood pressure and reduce left ventricular mass for peritoneal dialysis (PD) patients. This study investigated whether icodextrin use could reduce the risk of congestive heart failure (CHF) for PD patients.

METHODS: From the Taiwan National Health Insurance database, we identified 5462 newly diagnosed end-stage renal disease patients undergoing PD from 2005 to 2010. Incidence rates and hazard ratio of CHF were estimated for patients with and without icodextrin treatment by the end of 2011.

RESULTS: Among PD patients, icodextrin users had an overall 26% lower incidence of CHF than non-users (13.7 vs 18.6 per 1000 person-years). Relatively, the adjusted hazard ratio was 0.67 (95% CI = 0.52-0.87) for users compared with non-users. Among PD patients with diabetes, the incident CHF in icodextrin users was 37.5% lower than that in non-users (17.8 vs 28.5 per 1000 person-years). Among PD patients without diabetes, the incident CHF in icodextrin users was 30.4% lower than that in non-users (11.0 vs 15.8 per 1000 person-years).

CONCLUSIONS: Icodextrin solution could reduce the risk of new-onset CHF, particularly effective when diabetic PD patients use it.