Effects of icodextrin on glycemic and lipid profiles in diabetic patients undergoing peritoneal dialysis

Tetsuya Babazono, Hidetomo Nakamoto, Kenji Kasai, Satoru Kuriyama, Tokuichiro Sugimoto, Masaaki Nakayama, Chieko Hamada, Ryuichi Furuya, Hirofumi Hasegawa, Masato Kasahara, Misaki Moriishi, Tadashi Tomo, Masanobu Miyazaki, Manaka Sato, Noriaki Yorioka, Yoshindo Kawaguchi

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50 Citations (Scopus)

Abstract

Aim: Icodextrin reduces glucose absorption from the peritoneal dialysate. We conducted this prospective, open-labeled, multicenter study to determine the effects of icodextrin on glycemic and lipid parameters in diabetic patients undergoing continuous ambulatory peritoneal dialysis (PD) or automated PD. Methods: Patients were recruited from 15 institutions in Japan, and a total of 51 patients (15 women and 36 men, mean age: 59 ± 10 years, median duration of PD: 13 months) were enrolled. The patients were administered an overnight or daytime dwell of 1.5 or 2.0 l of 7.5% icodextrin-containing solution. At baseline and 3, 6, 9 and 12 months after the start of icodextrin, nonfasting blood was drawn for measurement of glycated hemoglobin (HbA1C) and serum lipids. Results: During icodextrin treatment, there was no change in overall HbA1C levels compared to baseline values; however, for those with baseline HbA1C ≥6.5% (n = 22), significant decreases in HbA1C were observed. Mean total/LDL cholesterol and triglycerides were decreased significantly during icodextrin treatment, with greater decreases for patients with baseline total cholesterol ≥220 mg/dl, LDL cholesterol ≥120 mg/dl or triglycerides ≥150 mg/dl. HDL cholesterol did not differ at any time point; however, values for patients with baseline HDL cholesterol <40 mg/dl tended to increase with marginal significance. Conclusions: In the current study, switching from glucose-containing dialysis solution to icodextrin resulted in improved lipid profiles and possibly a favorable metabolic profile, particularly in patients with poor glycemic control. These hypotheses remain to be proven in controlled clinical trials.

Original languageEnglish
Pages (from-to)409-415
Number of pages7
JournalAmerican Journal of Nephrology
Volume27
Issue number4
DOIs
Publication statusPublished - 2007 Jul 1

Keywords

  • Automated peritoneal dialysis
  • Cholesterol
  • Continuous ambulatory peritoneal dialysis
  • Diabetic nephropathy
  • Hemoglobin A1C
  • Icodextrin
  • Triglyceride

ASJC Scopus subject areas

  • Nephrology

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    Babazono, T., Nakamoto, H., Kasai, K., Kuriyama, S., Sugimoto, T., Nakayama, M., Hamada, C., Furuya, R., Hasegawa, H., Kasahara, M., Moriishi, M., Tomo, T., Miyazaki, M., Sato, M., Yorioka, N., & Kawaguchi, Y. (2007). Effects of icodextrin on glycemic and lipid profiles in diabetic patients undergoing peritoneal dialysis. American Journal of Nephrology, 27(4), 409-415. https://doi.org/10.1159/000105123