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Abstract: TH-PO420

Lower Risk of Hospitalizations in Cardiorenal Patients Using Once-Nightly Icodextrin Peritoneal Exchanges

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Saini, Ravleen Kaur, Avalon University School of Medicine, Youngstown, Ohio, United States
  • Bhullar, Jaibir, Avalon University School of Medicine, Youngstown, Ohio, United States
  • Jadidi, Shaheen, Midwestern University, Downers Grove , Illinois, United States
  • Rauf, Anis A., Nephrology Associates of Northern Illinois and Indiana , Oakrook , Illinois, United States
  • Rauf, Rayaan A., Advocate Good Samaritan Hospital, Downers Grove , Illinois, United States
Background

The purpose of this study is to investigate the benefits of using a nightly icodextrin peritoneal dialysis (PD) solution in the cardiorenal (diuretic-resistant congestive heart failure) patient. Icodextrin is a glucose polymer that has been used as a replacement for the glucose traditionally used in the PD long dwells, as the oncotic pressure gradient can be maintained at adequate ultrafiltration (UF) values for 8-12 hours during sleep. Icodextrin-based solutions (ICO) are well tolerated, lack the metabolic side effects of glucose, and enhance the clearance of small and middle-sized molecules as a consequence of increased convective flow. Patients using one exchange nightly lead a more “normal” life when compared to patients using continuous cycling peritoneal dialysis (CCPD) with glucose solutions, as CCPD requires a nightly cycler apparatus which restricts the patient ability to ambulate at night.

Methods

This study provides data from a sample size of 11 individuals (9 males and 2 females) currently on once-nightly icodextrin peritoneal exchanges. Hospital admissions over an equal date range before and after starting extraneal dialysis treatment were compared.

Results

In our study, we observed that patients using once-nightly icodextrin exchange had fewer hospitalizations (p=0.0149), and reported an overall better quality of life after initiation of icodextrin peritoneal dialysis with decreased hospital admissions for CHF and progressive chronic kidney disease.

Conclusion

By augmenting UF in the cardiorenal patient with recurrent episodes of decompensated heart failure through once-nightly icodextrin exchanges, patients receive adequate clearance with preserved residual renal function as well as fewer hospitalizations. In addition, patients report more restful sleep and a better quality of life as a result of not being attached to a machine at night. They also enjoy being able to travel with their solutions delivered to their destination without having to carry a cycler.