icodextrin and Coronary-Artery-Disease

Icodextrin-based peritoneal dialysis (PD) has many advantages over glucose-based PD. The present study aimed to investigate when icodextrin should be started for better management of cardiovascular status (as defined by echocardiography findings) and residual renal function (RRF). We retrospectively analyzed 40 patients treated with continuous ambulatory PD or automated PD. The patients were divided into these groups: Group A: started icodextrin within 2 weeks after PD onset. Group B: started icodextrin 1 year after PD onset. Group C: started icodextrin 2 years after PD onset. Group D: never used icodextrin during the study period. At the start of PD, we observed no significant difference in left ventricular mass index (LVMI) or urine volume (UV) between the groups. At 4 years, LVMI and UV were both significantly improved in group A compared with group D. The amelioration in LVMI was negatively associated with phosphate elimination. Our study showed that icodextrin preserved RRF and ameliorated left ventricular hypertrophy. Moreover, the timing of icodextrin introduction in PD patients influenced the clinical effects, including progression of cardiac hypertrophy and RRF.

Topics: Adult; Aged; Aged, 80 and over; Comorbidity; Coronary Artery Disease; Female; Glucans; Glucose; Hemodialysis Solutions; Humans; Icodextrin; Kidney Failure, Chronic; Male; Middle Aged; Peritoneal Dialysis; Ultrafiltration

Among end-stage renal disease (ESRD) patients, cardiovascular disease is a common comorbidity and one of most important factors affecting clinical prognosis. Calcium deposition has been reported to correlate with plasma phosphate. Icodextrin (Ico)-based peritoneal dialysis (PD) has many advantages over glucose (Glu)-based PD. We aimed to identify factors that suppress arteriosclerosis and valvular disease in patients with ESRD and diabetes mellitus (DM) undergoing Ico-based PD. In this retrospective study, we evaluated the effects of Ico-based PD (n = 20) on phosphate elimination and cardiovascular disease progression in patients with ESRD andDM, and we compared the results with those for Glu-based PD (n = 20). Left ventricular mass index (LVMI) and aortic valve calcification (AVC) score were significantly decreased and daily phosphate elimination was significantly increased in the Ico group compared with the Glu group. Furthermore, mean daily phosphate elimination was significantly and negatively correlated with the amelioration in LVMI and AVC score. Our study suggests that, compared with glucose, icodextrin has the ability to eliminate more phosphate from the body, indicating that phosphate elimination might potentially be a means of controlling cardiovascular disease in PD patients with DM.

Topics: Adult; Aged; Calcinosis; Cardiomegaly; Coronary Artery Disease; Diabetic Nephropathies; Disease Progression; Female; Glucans; Glucose; Heart Valve Diseases; Heart Valves; Hemodialysis Solutions; Humans; Hyperphosphatemia; Icodextrin; Kidney Failure, Chronic; Male; Middle Aged; Phosphates; Retrospective Studies

Topics: Adult; Blood Glucose; Computers, Handheld; Coronary Artery Disease; Diabetes Mellitus; Diagnostic Errors; Dialysis Solutions; Glucans; Glucose; Humans; Hypoglycemia; Icodextrin; Kidney Failure, Chronic; Male; Peritoneal Dialysis; Reproducibility of Results