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Nephron. 2018 Nov 13:1-7. doi: 10.1159/000494511. [Epub ahead of print]

Icodextrin is Associated with a Lower Risk of Stroke in Peritoneal Dialysis Patients.

Chiu CW1,2,3, Tsai TH1,4, Lin CL5, Yen TH6,7, Wang IK8,9,10, Li CY1,11.

Author information

1
Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
2
Department of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
3
Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan.
4
Division of Urology, Department of Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.
5
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
6
Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.
7
Chang Gung University College of Medicine, Taoyuan, Taiwan.
8
Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwanikwang@seed.net.tw.
9
Department of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwanikwang@seed.net.tw.
10
Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwanikwang@seed.net.tw.
11
Department of Anesthesiology, China Medical University Hospital, Taichung, Taiwan.

Abstract

BACKGROUND/AIMS:

This study investigated whether peritoneal dialysis (PD) patients using icodextrin were at a reduced risk of stroke.

METHODS:

From Taiwan National Health Insurance data, it was found that there were 6,796 new end-stage renal disease patients undergoing dialysis between 2005 and 2011. We compared the risk of stroke between PD patients with or without icodextrin treatment. The follow-up period began from the date of PD initiation to the end of 2011. The time-dependent Cox proportional hazards regression models were used to analyze the risk of stroke.

RESULTS:

Among PD patients, the icodextrin users had both a lower incidence and risk of stroke than icodextrin non-users (incidence: 22.4 vs. 25.2/1,000 person-years) with an adjusted hazard ratio of 0.76 (95% CI 0.63-0.93). The results were similar in models considering death a competing risk (overall: adjusted subhazard ratio [SHR] 0.78, 95% CI 0.63-0.94). Icodextrin users also had a lower risk of ischemic stroke with or without considering death a competing risk (adjusted SHR 0.71, 95% CI 0.57-0.89 and adjusted HR 0.74, 95% CI 0.59-0.93, respectively), compared to non-users.

CONCLUSION:

The use of icodextrin is associated with a lower incidence and risk of stroke in PD patients.

KEYWORDS:

Icodextrin; Peritoneal dialysis; Stroke

PMID:
30423579
DOI:
10.1159/000494511

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