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

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...

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Detalles Bibliográficos
Autores principales: Yi, Joo-Hark, Park, Jae-Il, Choi, Hoon-Young, Lee, Ho-Yung, Han, Sang-Woong, Kim, Ho-Jung
Formato: Texto
Lenguaje:English
Publicado: The Korean Society of Electrolyte Metabolism 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041488/
https://www.ncbi.nlm.nih.gov/pubmed/21468190
http://dx.doi.org/10.5049/EBP.2009.7.2.79
Descripción
Sumario: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≤56, P<0.001). Serum albumin, creatinine, total CO(2), 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.