Possible Interaction: Glucose and Icodextrin

“Computer simulations based on the three-pore theory suggest that a combination of 1.36% glucose and 7.5% icodextrin (glucose polymer) offers an improved ultrafiltration profile.”

“Of course, there is considerable evidence of adverse effects to the peritoneal membrane from prolonged glucose exposure, and because icodextrin offers the potential to reduce glucose in the dialysis prescription, the clinical benefit needs to be balanced against studies that have identified a possible inflammatory signal (10).”

“Using the doughnut rat model of mesothelial regeneration, exposure to 4.25% glucose or 7.5% icodextrin solutions severely hampered repopulation of the monolayer, which was replaced by a thick sheet of fibrous tissue.”

“Also the use of icodextrin once, or even twice, daily (26,27) reduces the glucose load.”

“Icodextrin solution enhances fluid and sodium removal, and the once-daily use of icodextrin and/or amino acid solutions can lessen the harmful effects caused by the exposure of the peritoneal membrane to glucose.”

“Adjusting the acidity in 1.5% dextrose and icodextrin dialysate significantly attenuated the dialysate-induced ROS generation and cell death in HPMCs.”

“Conclusions An ex vivo model to study the relationship between amylase activity and the actual rate of carbohydrate (represented by G7) breakdown was developed and showed that PD patients using glucose and icodextrin degrade G7 at a slower speed than controls.”

“The G7 degradation rate was slower in plasma from icodextrin patients but it was also reduced in patients using glucose compared with the controls, in spite of the higher amylase activity in the glucose group.”

“The UF for 8-hour dwells increased significantly 12 weeks after the start of icodextrin (356.3 +/- 102.9 mL with 2.5% glucose at baseline vs. 517.5 +/- 102.8 mL with icodextrin, p < 0.001).”

“In conclusion, sodium deoxycholate and glucose , but not methylglyoxal, intensify peritoneal transport of icodextrin in vitro.”

“The introduction of glucose into the circulating medium with icodextrin caused the increase of P values for glucose polymer by 94% during 60 min.”

“Conclusion: The long-term use of Icodextrin does not affect small molecule transport, but induces changes in the peritoneal protein excretion, especially when Icodextrin and glucose are injected together.”