Icodextrin produces higher ultrafiltration in diabetic than in non-diabetic patients on continuous cyclic peritoneal dialysis

A preliminary report from our unit previously suggested that diabetic patients on continuous cyclic peritoneal dialysis (CCPD) have higher ultrafiltration (UF) with icodextrin than non-diabetic patients. To confirm this observation, we did a retrospective analysis of our patients (17 diabetic and 23 non-diabetic) who were on stable CCPD prescription using a long-day dwell with icodextrin. We collected daily UF data from these patients’ records for 30 days. The two groups showed no significant difference with respect to age, gender, hemoglobin, serum albumin, peritoneal dialysis and icodextrin vintage, peritoneal membrane characteristics, CCPD prescription, and peritoneal and residual renal clearance. The overnight net UF achieved with the cycler with standard glucose dialysate was similar in the two groups (850 ± 379 in diabetic vs 713 ± 484 ml/day in non-diabetic, P = 0.34). However, UF with icodextrin during the day dwell (14.8 ± 0.8 h) was significantly higher in diabetics than non-diabetics (348 ± 198 vs 137 ± 311 ml/day, P = 0.02). Our results show that icodextrin produces significantly higher UF in long-day dwell in diabetic ESRD patients on CCPD than in non-diabetic patients. The reason for this difference is not clear.