Future of icodextrin as an osmotic agent in peritoneal dialysis

Abstract

In summary, the use of icodextrin as an osmotic agent increases ultrafiltration during the long dwell in PD patients, particularly during peritonitis and in high transporters. Thus, the effect of icodextrin is most powerful precisely in those patients who need it most, namely the high transporters. A major advantage is that icodextrin provides increased ultrafiltration and clearances during long dwells, while avoiding problems with excessive glucose absorption. Various unwanted systemic and local effects of the standard glucose-based dialysis solutions can be avoided with the use of icodextrin (Table 2), and this may potentially improve both technique survival and patient survival especially in PD patients with inadequate UF. Therefore, it is likely that the icodextrin-based solution will be the standard solution for the long dwell in the majority of PD patients in the future.