What is Icodextrin peritoneal dialysis solution?
01,What is Icodextrin peritoneal dialysis solution?
Icodextrin peritoneal dialysis solution is a specialized dialysis fluid used in peritoneal dialysis (PD) to remove waste and excess fluid from the body when the kidneys are not functioning properly. It's an alternative to dextrose-based solutions, offering sustained ultrafiltration for longer dwell times. This solution is particularly useful for patients on continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD).
Icodextrin peritoneal dialysis fluid is a peritoneal dialysis solution containing colloidal icodextrin. Icodextrin is a water-soluble glucose polymer of starch derivatives connected by α(1-4) and less than 10% α(1-6) glycosidic bonds. The weight-average molecular weight is 13,000 to 19,000 Daltons, and the number-average molecular weight is 5,000 to 6,500 Daltons. It has the characteristics of isotonicity, low glucose content and low metabolites. Icodextrin peritoneal dialysis fluid contains 7.5% starch polysaccharide (Icodextrin). Since the starch polysaccharide Icodextrin is a macromolecular polymer with a large molecular volume, it cannot directly diffuse through the peritoneal wall into the peritoneal microvessels for absorption by the body. Therefore, a high colloidal osmotic pressure is generated in the peritoneal cavity to maintain the dehydration and clearance efficiency during the retention period.
02, Domestic and overseas usage:
This product was first developed by ATTELION in the United States and approved by Baxter Healthcare in 2002. Baxter's new peritoneal dialysis solution Icodextrin was approved for marketing in Japan on July 18, 2003, under the trade name: Extraneal. More than 130 countries around the world have used this peritoneal dialysis solution. Extraneal is currently available in China.
03. Comparison with traditional glucose peritoneal dialysis solution:
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Glucose peritoneal dialysis solution |
Icodextrin peritoneal dialysis solution |
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Biocompatibility |
Degradation occurs after long-term use. The advanced glycosylation products bind to peritoneal cell receptors to stimulate the release of multiple cytokines, induce local and systemic inflammatory responses, and destroy the peritoneal structure and function. |
Isotonic, osmotic pressure is 284 mOsmol/L, which is closer to the physiological needs of the human body. It reduces angiogenesis and fibrosis factors such as vascular endothelial growth factor and advanced glycation end products, and delays the deterioration of peritoneal function. |
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Protecting residual renal function |
Contains high levels of glucose degradation products and advanced glycation end products, which affect residual renal function |
Lower glucose degradation products and advanced glycation end products are beneficial for protecting residual renal function |
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Improve metabolism |
Absorption of 100-300 g of glucose via peritoneal dialysis fluid every day can easily lead to obesity, insulin resistance, glucose metabolism disorders, arteriosclerosis, cardiovascular and cerebrovascular diseases |
It contains less sugar and has a low absorption rate, which can effectively avoid metabolic disorders; it can reduce the amount of insulin, reduce metabolic disorders in diabetic and non-diabetic patients, and improve insulin resistance, diabetes control, and lipid profile. |
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Dehydration efficiency |
Excessive dehydration each time can lead to low blood pressure, muscle cramps, vomiting, irritability, etc. |
The change in body weight has little effect and will not cause a significant change in dehydration |
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03,Indications and Usage:
Indications: Icodextrin peritoneal dialysis solution is used for single daily exchange in patients with long-term (8-16 hours) indwelling peritoneal dialysis during continuous ambulatory peritoneal dialysis (CAPD) or for automated peritoneal dialysis (APD) for the treatment of end-stage renal disease. This product can also be used for patients with high transport and high average transport determined by peritoneal equilibrium test.
Dosage and Administration: This product is only used for intraperitoneal administration, twice a day, for peritoneal dialysis. The recommended dialysis time is 8 to 16 hours.
Specifications: 1.5L, 2.0L, 2.5L
04,Summary:
Compared with traditional glucose dialysate, icodextrin peritoneal dialysis solution has many advantages, including better biocompatibility, ability to protect residual renal function, ability to effectively avoid adverse events such as metabolic disorders, good ultrafiltration function, and efficient positive net ultrafiltration function that can be maintained for 16 h, which is beneficial to ultrafiltration and capacity management in peritoneal dialysis patients.