Effect of icodextrin solution on the preservation of residual renal function in peritoneal dialysis patients

A randomized controlled study

behalf of the Yonsei Associate Network CHronic Kidney Disease Trial (YACHT) investigators

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Although icodextrin solution has been highlighted in the fluid management compared to glucose-based solutions, proof of a beneficial effect of icodextrin solution on residual renal function (RRF) is lacking. We conducted a multicenter prospective randomized controlled open-label trial to investigate whether icodextrin solution can preserve RRF. One hundred patients with urine volume ≥750 mL/day from 8 centers in Korea were randomly assigned to receive 1 exchange of icodextrin solution for a ≥8 hour-dwell time and 2 exchanges of 1.5% glucose-based biocompatible neutral pH solution or 1 exchange of ≥2.5% and 2 exchanges of 1.5% glucose-based biocompatible solutions. Using mixed-effects general linear models, we analyzed changes in residual glomerular filtration rate (GFR) and daily urine volume at 1 year. Forty-nine patients were assigned to the icodextrin group and 51 to the glucose solution group. During follow-up, the slope of the decline in residual GFR was -0.170 mL/min/month/1.73m2 in the icodextrin group, while it was -0.155 mL/min/month/1.73m2 in the glucose solution group (95% confidence interval [CI], -0.06 to 0.10; P=0.701). Daily urine volume decreased faster in the glucose solution group than in the icodextrin group (-31.02 vs -11.88mL per month; 95% CI, -35.85 to -2.44; P=0.025). Results were consistent when we analyzed using intention-to-treat and per protocol principles. There were no differences in fluid status, peritoneal ultrafiltration, and peritoneal transport between groups during follow-up. This study clearly showed that icodextrin solution preserves residual urine volume better than glucose solution.

Original languageEnglish
Pages (from-to)e2991
JournalMedicine (United States)
Volume95
Issue number13
DOIs
Publication statusPublished - 2016 Jan 1

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Peritoneal Dialysis
Kidney
Glucose
Urine
Glomerular Filtration Rate
icodextrin
Confidence Intervals
Residual Volume
Ascitic Fluid
Ultrafiltration
Korea
Linear Models

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

behalf of the Yonsei Associate Network CHronic Kidney Disease Trial (YACHT) investigators. / Effect of icodextrin solution on the preservation of residual renal function in peritoneal dialysis patients : A randomized controlled study. In: Medicine (United States). 2016 ; Vol. 95, No. 13. pp. e2991.
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abstract = "Although icodextrin solution has been highlighted in the fluid management compared to glucose-based solutions, proof of a beneficial effect of icodextrin solution on residual renal function (RRF) is lacking. We conducted a multicenter prospective randomized controlled open-label trial to investigate whether icodextrin solution can preserve RRF. One hundred patients with urine volume ≥750 mL/day from 8 centers in Korea were randomly assigned to receive 1 exchange of icodextrin solution for a ≥8 hour-dwell time and 2 exchanges of 1.5{\%} glucose-based biocompatible neutral pH solution or 1 exchange of ≥2.5{\%} and 2 exchanges of 1.5{\%} glucose-based biocompatible solutions. Using mixed-effects general linear models, we analyzed changes in residual glomerular filtration rate (GFR) and daily urine volume at 1 year. Forty-nine patients were assigned to the icodextrin group and 51 to the glucose solution group. During follow-up, the slope of the decline in residual GFR was -0.170 mL/min/month/1.73m2 in the icodextrin group, while it was -0.155 mL/min/month/1.73m2 in the glucose solution group (95{\%} confidence interval [CI], -0.06 to 0.10; P=0.701). Daily urine volume decreased faster in the glucose solution group than in the icodextrin group (-31.02 vs -11.88mL per month; 95{\%} CI, -35.85 to -2.44; P=0.025). Results were consistent when we analyzed using intention-to-treat and per protocol principles. There were no differences in fluid status, peritoneal ultrafiltration, and peritoneal transport between groups during follow-up. This study clearly showed that icodextrin solution preserves residual urine volume better than glucose solution.",
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Effect of icodextrin solution on the preservation of residual renal function in peritoneal dialysis patients : A randomized controlled study. / behalf of the Yonsei Associate Network CHronic Kidney Disease Trial (YACHT) investigators.

In: Medicine (United States), Vol. 95, No. 13, 01.01.2016, p. e2991.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of icodextrin solution on the preservation of residual renal function in peritoneal dialysis patients

T2 - A randomized controlled study

AU - behalf of the Yonsei Associate Network CHronic Kidney Disease Trial (YACHT) investigators

AU - Chang, Tae Ik

AU - Ryu, Dong Ryeol

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