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Icodextrin decreases technique failure and improves patient survival in peritoneal dialysis patients.

AbstractAIM:
It remains unclear whether long-term daily icodextrin use can decrease technique failure and improve survival in peritoneal dialysis (PD) patients. The aim of the present study was to investigate whether icodextrin use, once daily, can decrease technique failure and prolong patient survival in incident PD patients.
METHODS:
Incident PD patients who survived more than 90 days were recruited from the China Medical University Hospital, Taiwan, between 1 January 2007 and 31 December 2011. All patients were followed until transfer to haemodialysis (HD), renal transplantation, transfer to another centre, death, or 31 December 2011.
RESULTS:
A total of 306 incident PD patients (89 icodextrin users, 217 icodextrin non-users) were recruited during the study period. Icodextrin users were more likely to have hypertension, diabetes and high or high-average peritoneal transport compared with non-users. During the follow-up period, 43 patients were transferred to HD: seven (7.87%) of the icodextrin group, and 36 (16.59%) of the non-icodextrin group. Thirty-two patients died during the follow-up period: five (5.62%) of the icodextrin group, and 27 (12.44%) of the non-icodextrin group. Icodextrin use was significantly associated with a better prognosis, in terms of technique failure (adjusted HR = 0.32; 95% CI = 0.14-0.72). With regard to patient survival, icodextrin use (adjusted HR = 0.33; 95% CI = 0.12-0.87) was associated with a significantly lower risk of death.
CONCLUSION:
The use of icodextrin once daily may decrease technique failure and improve survival in incident PD patients.
AuthorsI-Kuan Wang, Yu-Fen Li, Jin-Hua Chen, Chih-Chia Liang, Yao-Lung Liu, Hsin-Hung Lin, Chiz-Tzung Chang, Wen-Chen Tsai, Tzung-Hai Yen, Chiu-Ching Huang
JournalNephrology (Carlton, Vic.) (Nephrology (Carlton)) Vol. 20 Issue 3 Pg. 161-7 (Mar 2015) ISSN: 1440-1797 [Electronic] Australia
PMID25487756 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2014 Asian Pacific Society of Nephrology.
Chemical References
  • Dialysis Solutions
  • Glucans
  • Icodextrin
  • Glucose
Topics
  • Adult
  • Aged
  • Comorbidity
  • Dialysis Solutions (therapeutic use)
  • Female
  • Glucans (therapeutic use)
  • Glucose (therapeutic use)
  • Humans
  • Icodextrin
  • Incidence
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic (diagnosis, mortality, therapy)
  • Male
  • Middle Aged
  • Peritoneal Dialysis (adverse effects, mortality)
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Taiwan (epidemiology)
  • Time Factors
  • Treatment Failure

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