Electrolyte Blood Press.  2009 Dec;7(2):79-86. 10.5049/EBP.2009.7.2.79.

Icodextrin Improves the Serum Potassium Profile with the Enhancement of Nutritional Status in Continuous Ambulatory Peritoneal Dialysis Patients

• Yi JH
• Park JI
• Choi HY
• Lee HY
• Han SW
• Kim HJ

• KMID: 2052323
• DOI: http://doi.org/10.5049/EBP.2009.7.2.79

Abstract

The impact of glucose-free icodextrin (ID) for overnight dwell as compared to conventional glucose-containing dialysate (GD) on potassium (K+) metabolism in continuous ambulatory peritoneal dialysis (CAPD) patients has not yet been investigated. Serum K+ in a total of 255 stable patients (116 on GD and 139 on ID) on CAPD for more than 6 months and in 139 patients on ID before and after ID use (Pre-ID and Post-ID) were observed along with nutritional markers in a 2-year study period (Jan. 2006 to Dec. 2007). The prevalence of hypokalemia was similar between patients on GD and ID (16.7% vs 17.3%), but was lower on Post-ID than Pre-ID (17.3% vs 20.5%) without statistic significance. The mean serum K+ level was higher on ID than on GD (P<0.05) as well as Post-ID than Pre-ID (P<0.001). In the multivariate analysis, serum K+ levels were positively correlated with serum albumin, and creatinine in all patients (P<0.05), and ID-use in younger patients (age< or =56, P<0.001). Serum albumin, creatinine, total CO2, and body mass index were significantly higher on Post-ID than Pre-ID. Icodextrin dialysate for chronic overnight dwell could increase serum K+ levels and lower the prevalence of hypokalemia compared to conventional glucose-containing dialysate. The improved chronic K+ balance in CAPD patients on icodextrin could be related to enhanced nutritional status rather than its impact on acute intracellular K+ redistribution.

Keyword

serum albumin; hypokalemia; icodextrin; nutritional status; peritoneal dialysis

MeSH Terms

Body Mass Index
Creatinine
Glucans
Glucose
Humans
Hypokalemia
Multivariate Analysis
Nutritional Status
Peritoneal Dialysis
Peritoneal Dialysis, Continuous Ambulatory
Potassium
Prevalence
Serum Albumin
Creatinine
Glucans
Glucose
Potassium
Serum Albumin

Figure

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  Fig. 1 The prevalence of hypokalemia between patients treated with glucose-containing dialysate (GD, n=116) and icodextrin (ID, n=139), and before (Pre-ID) and after (Post-ID) changing to icodextrin in 139 patients on icodextrin (ID). GD, glucose-containing dialysate; ID, non-glucose-containing dialysate, icodextrin; Pre-ID, before icodextrin, i.e. on GD; Post-ID, after icodextrin.

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