Long Peritoneal Dialysis Dwells With Icodextrin: Kinetics of Transperitoneal Fluid and Polyglucose Transport

Background and objective: During peritoneal dialysis (PD), the period of effective net peritoneal ultrafiltration during long dwells can be extended by using the colloidal osmotic agent icodextrin but there are few detailed studies on ultrafiltration with icodextrin solution exceeding 12 hours. We analysed kinetics of peritoneal ultrafiltration in relation to icodextrin and its metabolites for 16-hours dwells with icodextrin. Design, setting, participants, & measurements: In 20 clinically stable patients (mean age 54 years; 8 women; mean preceding time on PD 26 months), intraperitoneal dialysate volume (VD) was estimated from dilution of 125I-human serum albumin during 16-h dwell studies with icodextrin 7.5% solution. Osmolality and sodium were measured in dialysate and plasma. In 11 patients, fractional absorption of icodextrin from dialysate, dialysate and plasma amylase, and high and low (Mw