Effects of Icodextrin on Glycemic and Lipid Profiles in Diabetic Patients Undergoing Peritoneal Dialysis
- 1 July 2007
- journal article
- clinical trial
- Published by S. Karger AG in American Journal of Nephrology
- Vol. 27 (4), 409-415
- https://doi.org/10.1159/000105123
Abstract
Aim: Icodextrin reduces glucose absorption from the peritoneal dialysate. We conducted this prospective, open-labeled, multicenter study to determine the effects of icodextrin on glycemic and lipid parameters in diabetic patients undergoing continuous ambulatory peritoneal dialysis (PD) or automated PD. Methods: Patients were recruited from 15 institutions in Japan, and a total of 51 patients (15 women and 36 men, mean age: 59 ± 10 years, median duration of PD: 13 months) were enrolled. The patients were administered an overnight or daytime dwell of 1.5 or 2.0 l of 7.5% icodextrin-containing solution. At baseline and 3, 6, 9 and 12 months after the start of icodextrin, nonfasting blood was drawn for measurement of glycated hemoglobin (HbA1C) and serum lipids. Results: During icodextrin treatment, there was no change in overall HbA1C levels compared to baseline values; however, for those with baseline HbA1C ≧6.5% (n = 22), significant decreases in HbA1C were observed. Mean total/LDL cholesterol and triglycerides were decreased significantly during icodextrin treatment, with greater decreases for patients with baseline total cholesterol ≧220 mg/dl, LDL cholesterol ≧120 mg/dl or triglycerides ≧150 mg/dl. HDL cholesterol did not differ at any time point; however, values for patients with baseline HDL cholesterol Conclusions: In the current study, switching from glucose-containing dialysis solution to icodextrin resulted in improved lipid profiles and possibly a favorable metabolic profile, particularly in patients with poor glycemic control. These hypotheses remain to be proven in controlled clinical trials.Keywords
This publication has 28 references indexed in Scilit:
- Benefit of Glucose-Free Dialysis Solutions on Glucose and Lipid Metabolism in Peritoneal Dialysis PatientsBlood Purification, 2005
- 2004 Japanese Society for Dialysis Therapy Guidelines for Renal Anemia in Chronic Hemodialysis Patients*Therapeutic Apheresis and Dialysis, 2004
- Conditions associated with very low values of glycohaemoglobin measured by an HPLC methodJournal of Clinical Pathology, 2004
- Glycemic control in diabetic CAPD patients assessed by continuous glucose monitoring system (CGMS)Kidney International, 2003
- Dialysis modalities and dyslipidemiaKidney International, 2003
- Metabolic and laboratory effects of icodextrinKidney International, 2002
- Association of postprandial hypertriglyceridemia and carotid intima-media thickness in patients with type 2 diabetes.Diabetes Care, 2000
- Influence of Erythropoietin Treatment on Hemoglobin A1c Levels in Patients with Chronic Renal Failure on Hemodialysis.Internal Medicine, 1998
- Serum Glycated Albumin and Fructosamine in Renal Dialysis PatientsNephron, 1993
- Some Monte Carlo results on the power of the F-test under permutation in the simple randomized block designBiometrika, 1966