Peritoneal Dialysis Iv Icodextrine Based

What it is and how it works

Contains icodextrin, a starch-derived glucose polymer, as the osmotic agent with electrolytes and a lactate buffer. Because icodextrin is a large molecule absorbed slowly via the lymphatics, it acts as a colloid osmotic agent and produces sustained ultrafiltration over long dwells (8–16 hours) without the large glucose load of hypertonic glucose solutions.

Indications

Once-daily replacement of a single glucose exchange for the long dwell in CAPD (overnight) or APD (daytime) in patients with chronic kidney failure, particularly those with high-transport membranes or inadequate ultrafiltration on glucose solutions.

Dosage and administration (summary)

Dosing is individualised by the nephrologist: usually one exchange per day only, for the long dwell, with fill volume according to the patient.

Contraindications

Known allergy to starch-based polymers or icodextrin, maltose or isomaltose intolerance, glycogen storage disease, pre-existing severe lactic acidosis, and the general contraindications to peritoneal dialysis (e.g. uncorrectable mechanical defects, loss of peritoneal function, extensive adhesions).

Warnings and precautions

Icodextrin metabolites (maltose) cause falsely elevated glucose readings with glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ) or glucose-dye-oxidoreductase based meters and test strips, which may mask true hypoglycaemia; use glucose-specific methods. Sterile peritonitis and skin reactions, including rash and exfoliative reactions, have been reported. Monitor fluid status, as excessive ultrafiltration may cause dehydration.

Pregnancy

Data are limited; use only if clearly necessary.

Storage and supply

Store below 25–30 °C; do not freeze; keep in the overpouch until use.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.