Icodextrin versus Glucose 2.5% on markers of hypervolemia and survival of patients undergoing automated peritoneal dialysis with an unplanned start: a randomized controlled trial
ABSTRACT Objective: The efficacy of icodextrin versus glucose patients undergoing peritoneal dialysis remains unclear. The study was designed to compare the effects of once-daily long-dwell icodextrin versus glucose on markers of hypervolemia and survival among patients with kidney failure undergoi...
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Instituto Israelita de Ensino e Pesquisa Albert Einstein
2024-12-01
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| author | Leonardo Sotello Azevedo Vanessa Burgugi Banin Dayana Bitencourt Dias Marcela Lara Mendes Camila Albuquerque Alves Maryanne Zilli Canedo Silva Thyago Proença de Moraes Daniela Ponce |
| author_facet | Leonardo Sotello Azevedo Vanessa Burgugi Banin Dayana Bitencourt Dias Marcela Lara Mendes Camila Albuquerque Alves Maryanne Zilli Canedo Silva Thyago Proença de Moraes Daniela Ponce |
| author_sort | Leonardo Sotello Azevedo |
| collection | DOAJ |
| description | ABSTRACT Objective: The efficacy of icodextrin versus glucose patients undergoing peritoneal dialysis remains unclear. The study was designed to compare the effects of once-daily long-dwell icodextrin versus glucose on markers of hypervolemia and survival among patients with kidney failure undergoing an unplanned initiation of automated peritoneal dialysis. Methods: This was a randomized, non-blinded, and prospective controlled study. Prevalent and stable patients undergoing automated peritoneal dialysis with a recent peritoneal equilibration test showing a dialysate/plasma creatinine of >0.50 were randomized to receive either 7.5% icodextrin or 2.5% glucose solution. Patients were evaluated at baseline (one month after the start of peritoneal dialysis), 3 months, and 6 months after inclusion. The peritoneal dialysis solution was used for at least 3 months, with a follow-up period of 24 months. Results: Thirty patients were enrolled. There were no baseline differences between the groups. During the study period, patients in the Icodextrin Group showed improvements in the phase angle and ultrafiltration, whereas there were no changes in the Glucose Group. Additionally, extracellular water was significantly lower in the Icodextrin Group at the end of the study than at baseline. No statistical differences between the two groups were observed in urine volume, ultrafiltration, extracellular water, phase angle, renal creatinine clearance, use of diuretics and antihypertensives, or blood pressure. During the 24-month follow-up, the number of events related to overall mortality was seven (Icodextrin Group, n=4; Glucose Group, n=3), with no difference between the groups for this outcome or technique survival. Conclusion: Icodextrin significantly improved ultrafiltration, extracellular water, and phase angle at the end of the study compared to baseline in patients on the urgent start of automated peritoneal dialysis. Registry of Clinical Trials: (www.ctri.nic.in) under the number RBR-97z4wh6. |
| format | Article |
| id | doaj-art-3ac23c34869c4d38a5a198e139f75928 |
| institution | Kabale University |
| issn | 2317-6385 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Instituto Israelita de Ensino e Pesquisa Albert Einstein |
| record_format | Article |
| series | Einstein (São Paulo) |
| spelling | doaj-art-3ac23c34869c4d38a5a198e139f759282024-12-17T07:52:42ZengInstituto Israelita de Ensino e Pesquisa Albert EinsteinEinstein (São Paulo)2317-63852024-12-012210.31744/einstein_journal/2024ao0980Icodextrin versus Glucose 2.5% on markers of hypervolemia and survival of patients undergoing automated peritoneal dialysis with an unplanned start: a randomized controlled trialLeonardo Sotello Azevedohttps://orcid.org/0000-0002-0874-9919Vanessa Burgugi Baninhttps://orcid.org/0000-0003-3516-3312Dayana Bitencourt Diashttps://orcid.org/0000-0002-8687-4037Marcela Lara Mendeshttps://orcid.org/0000-0002-4033-0106Camila Albuquerque Alveshttps://orcid.org/0000-0001-6671-2287Maryanne Zilli Canedo Silvahttps://orcid.org/0000-0001-6602-3625Thyago Proença de Moraeshttps://orcid.org/0000-0002-2983-3968Daniela Poncehttps://orcid.org/0000-0002-6178-6938ABSTRACT Objective: The efficacy of icodextrin versus glucose patients undergoing peritoneal dialysis remains unclear. The study was designed to compare the effects of once-daily long-dwell icodextrin versus glucose on markers of hypervolemia and survival among patients with kidney failure undergoing an unplanned initiation of automated peritoneal dialysis. Methods: This was a randomized, non-blinded, and prospective controlled study. Prevalent and stable patients undergoing automated peritoneal dialysis with a recent peritoneal equilibration test showing a dialysate/plasma creatinine of >0.50 were randomized to receive either 7.5% icodextrin or 2.5% glucose solution. Patients were evaluated at baseline (one month after the start of peritoneal dialysis), 3 months, and 6 months after inclusion. The peritoneal dialysis solution was used for at least 3 months, with a follow-up period of 24 months. Results: Thirty patients were enrolled. There were no baseline differences between the groups. During the study period, patients in the Icodextrin Group showed improvements in the phase angle and ultrafiltration, whereas there were no changes in the Glucose Group. Additionally, extracellular water was significantly lower in the Icodextrin Group at the end of the study than at baseline. No statistical differences between the two groups were observed in urine volume, ultrafiltration, extracellular water, phase angle, renal creatinine clearance, use of diuretics and antihypertensives, or blood pressure. During the 24-month follow-up, the number of events related to overall mortality was seven (Icodextrin Group, n=4; Glucose Group, n=3), with no difference between the groups for this outcome or technique survival. Conclusion: Icodextrin significantly improved ultrafiltration, extracellular water, and phase angle at the end of the study compared to baseline in patients on the urgent start of automated peritoneal dialysis. Registry of Clinical Trials: (www.ctri.nic.in) under the number RBR-97z4wh6.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082024000100255&lng=en&tlng=enRenal insufficiency, chronicPeritoneal dialysisIcodextrinGlucoseUrgent startHypervolemiaSurvival |
| spellingShingle | Leonardo Sotello Azevedo Vanessa Burgugi Banin Dayana Bitencourt Dias Marcela Lara Mendes Camila Albuquerque Alves Maryanne Zilli Canedo Silva Thyago Proença de Moraes Daniela Ponce Icodextrin versus Glucose 2.5% on markers of hypervolemia and survival of patients undergoing automated peritoneal dialysis with an unplanned start: a randomized controlled trial Einstein (São Paulo) Renal insufficiency, chronic Peritoneal dialysis Icodextrin Glucose Urgent start Hypervolemia Survival |
| title | Icodextrin versus Glucose 2.5% on markers of hypervolemia and survival of patients undergoing automated peritoneal dialysis with an unplanned start: a randomized controlled trial |
| title_full | Icodextrin versus Glucose 2.5% on markers of hypervolemia and survival of patients undergoing automated peritoneal dialysis with an unplanned start: a randomized controlled trial |
| title_fullStr | Icodextrin versus Glucose 2.5% on markers of hypervolemia and survival of patients undergoing automated peritoneal dialysis with an unplanned start: a randomized controlled trial |
| title_full_unstemmed | Icodextrin versus Glucose 2.5% on markers of hypervolemia and survival of patients undergoing automated peritoneal dialysis with an unplanned start: a randomized controlled trial |
| title_short | Icodextrin versus Glucose 2.5% on markers of hypervolemia and survival of patients undergoing automated peritoneal dialysis with an unplanned start: a randomized controlled trial |
| title_sort | icodextrin versus glucose 2 5 on markers of hypervolemia and survival of patients undergoing automated peritoneal dialysis with an unplanned start a randomized controlled trial |
| topic | Renal insufficiency, chronic Peritoneal dialysis Icodextrin Glucose Urgent start Hypervolemia Survival |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082024000100255&lng=en&tlng=en |
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