Icodextrin re-absorption varies with age in children on automated peritoneal dialysis

Information on the use of Icodextrin in children remains scarce; however, it is believed that the characteristics are similar across all ages. We report the use of Icodextrin in a cohort of pediatric automated peritoneal dialysis (APD) patients younger than those previously reported (n =8, median age of 2.8, range 0.02–17.1 years). Net Icodextrin daytime dwell ultrafiltration was calculated in each patient for every day on therapy as ml/h/m². Half of the patients showed re-absorption even when reducing Icodextrin dwells from a median of 10 to 6 h. All four patients who re-absorbed the Icodextrin (ranging from −23.7±7.5 to −2.5±6.0 ml/h/m²) were treated with cyclic nocturnal APD, and three of these four patients were high transporters on the peritoneal equilibration test (PET). Icodextrin fluid removal correlated significantly with age (Spearman rank r =0.8571, P =0.0107). The data suggest that Icodextrin behaves differently in young children.