Abstract: FR-OR073
Effects of Peritoneal Dialysis Modalities on Hypervolemic Patients: A Randomized Controlled Trial
Session Information
- What's New at Home (Dialysis)?
November 07, 2025 | Location: Room 351D, Convention Center
Abstract Time: 04:30 PM - 04:40 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Sritippayawan, Suchai, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Chuengsaman, Piyatida, Banphaeo Hospital (Public Organization), Bangkok, Thailand
- Srithongkul, Thatsaphan, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Raksasuk, Sukit, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Aiyasanon, Nipa, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Tongsai, Sasima, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
Group or Team Name
- APDICO Group.
Background
Limited data are available comparing clinical outcomes among peritoneal dialysis(PD) modalities in patients with volume overload. This study aims to evaluate the outcomes of hypervolemic patients treated with nightly intermittent PD(NIPD, no day dwell), continuous ambulatory PD (CAPD), and CAPD with icodextrin(ICO).
Methods
A total of 180 PD patients with volume overload were enrolled from 16 hospitals, randomized into 3 groups(n=60 each): NIPD, CAPD, ICO and followed for 3 years. The outcomes included patient and technique survivals, peritonitis rate, hospitalization, systolic and diastolic blood pressure(SBP/DBP), total weekly Kt/Vurea and creatinine clearance(CCr), lipid profiles, fasting blood glucose(FBG), HbA1c and glucose absorption, serum phosphate(P), daily ultrafiltration(UF) volume and sodium(Na) removal which were assessed every 2 - 4 months. Modified peritoneal equilibration test were evaluated every 6 months. Longitudinal data were analyzed using Generalized Estimating Equations to account for repeated measures and non-normal data distribution.
Results
Baseline characteristics were comparable among the 3 groups. At 3 years, patient survival adjusted for age, comorbidities, urine volume, and PD vintage was significantly higher in the ICO group(62%) compared to NIPD(38%) and CAPD(45%)(p<0.05). The ICO group also had fewer hospitalizations(65 vs. 92 in NIPD and 84 in CAPD). Technique survival was higher in the CAPD group than in NIPD, while peritonitis rates were comparable across all groups(CAPD=0.49, NIDP=0.57, and ICO=0.45 episode per year). Glucose absorption, serum glucose, and triglyceride levels were lower in the ICO group. UF volume was lower in the CAPD group, whereas Na removal was lowest in the NIPD group. SBP was higher in the ICO group(p<0.05). Serum phosphate was higher and phosphate removal was lower in NIPD group(p,0.05). There was no significant difference in total weekly Kt/Vurea across groups while the total normalized CCr was significantly lower in the NIPD group. The D/Pcr at 4 hours was similar among groups, but Na dip values were significantly higher in the ICO group at 3 years.
Conclusion
CAPD with icodextrin improves patient survival, reduces hospitalizations, lowers glucose absorption and triglyceride level compared to NIPD and conventional CAPD in hypervolemic PD patients.
Funding
- Government Support – Non-U.S.