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Int Urol Nephrol. 2018 Mar;50(3):495-500. doi: 10.1007/s11255-017-1647-2. Epub 2017 Jul 3.

Icodextrin and peritoneal dialysis: advantages and new applications.

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Hemodialysis Unit Kyanous Stavros Patras, Germanou 115, 26225, Patras, Greece.
Ageing Biology Unit, Nephrology Division, Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
Hemodialysis Unit Kyanous Stavros Patras, Germanou 115, 26225, Patras, Greece.


The impact of icodextrin (ico) on peritoneal dialysis (PD) extension and patient survival is well established. Predominantly, ico-based solutions were prescribed in high-transporter PD patients. Advantages of the ico-based solutions include increased biocompatibility, avoidance of glucotoxicity, enhanced ultrafiltration failure (UF), sodium removal rates, better metabolic and blood pressure control. Bimodal solutions and twice daily exchanges of ico-based solutions are two newly introduced strategies to avoid glucose exposure and/or enhance UF in PD patients with UF failure. In addition, a simplified schedule of PD using a single nocturnal exchange of ico in patients with refractory congestive heart failure may represent an alternative option to manage fluid removal and azotaemia. The use of a simplified schedule of PD with only two ico exchanges or a single ico exchange is a challenging approach for end-stage renal disease patients with preserved residual function who desire to initiate PD.


Bimodal solutions; Congestive heart failure; Icodextrin; Peritoneal dialysis; Utrafiltration failure


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