Delving into the Latest Updates on Icodextrin with Synapse

Volume overload is an important cause of technical failure in peritoneal dialysis patients. Icodextrin can provide continuous ultrafiltration, which provides a new option for peritoneal dialysis patients.
However, icodextrin metabolites are known to accumulate to some extent in the body, resulting in less ultrafiltration with long-term icodextrin use comparing with newly use.
Therefore, the investigator hypothesized that a single dose of icodextrin would produce more ultrafiltration volume with the use of icodextrin dialysate on alternate days than with the use of icodextrin dialysate on daily uses.

Start Date01 Aug 2023

Sponsor / Collaborator

Shanghai Renji Hospital

NCT05721404 / RecruitingPhase 4IIT

Icodextrin Postpones the Shift of Low Dose to Full Dose Dialysis in the First Year of Incremental Peritoneal Dialysis: A Randomized Controlled Trial

We hypothesize incremental peritoneal dialysis (incremental PD) protocol with icodextrin solution will help patients to achieve adequate ultrafiltration and adequate dialysis with less glucose exposure by manipulating a low frequency of exchanges, therefore prolong the time from incremental protocol to full dose protocol (Full dose dialysis is defined as a dialysis dose of more than 8 L (4 exchanges of 2 L) per day). The goal of this clinical trial is to investigate the effect of icodextrin postponing the shift of low dose to full dose dialysis in the first year of incremental peritoneal dialysis. The main questions are:
The effect of icodextrin on the shift of low dose to full dose dialysis in the first year in patients on incremental peritoneal dialysis.
The effect of icodextrin on clinical outcomes in patients on incremental peritoneal dialysis, such as the first episode of peritonitis, the incidence of anuria, the first incidence of hospitalization, technical failure, all cause mortality, cardiovascular disease free survival and the quality of life.
Participants will be 1:1 randomized to the ICO (icodextrin) arm and CON (control) arm. Both arms patients will be followed every 2 months for fluid status by bioimpedance analysis. An extracellular water /total body water (ECW/TBW) ≥ 0.40 or edema is defined as overhydration (OH). The OH patients in the ICO arm will be prescribed icodextrin (Extraneal) for long night dwell to improve fluid overload till their re-measurement of ECW/TBW < 0.40 or edema disappeared. The OH patients in the CON arm will be prescribed hypertonic Dextrose solution for long night dwell to improve fluid overload till their ECW/TBW < 0.40 or edema disappeared.
Researchers will compare the time of transferring from low dose PD to full dose and the clinical outcomes in the first year between the patients in ICO and CON groups to see the effect of icodextrin on the shift of low dose to full dose dialysis and clinical outcomes in the first year in patients on incremental peritoneal dialysis. Successful completion of the study will advance our strategy of incremental PD and help to prolong the shift from incremental to full dose dialysis, and offer new opportunities for the development of an effective and economical therapy for PD patients with residual kidney function (RKF)

Start Date24 May 2023

Sponsor / Collaborator

Baxter Healthcare Corp.

NCT05780086 / RecruitingPhase 1IIT

A Phase I Study to Evaluate the Short-term Safety of and Tolerability to a Sodium-free Peritoneal Dialysis Solution With 30% Icodextrin and 10% Dextrose in Patients in Peritoneal Dialysis, on a Preliminary Basis

This study will evaluate the safety and tolerability profile of a dwell time (bath) of 24 hours using a 500 ml sodium-free peritoneal dialysis solution based on 30% icodextrin and 10% dextrose in patients with chronic kidney failure undergoing peritoneal dialysis

Start Date03 Feb 2023

Sponsor / Collaborator

Instituto Mexicano del Seguro Social

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100 Clinical Results associated with Icodextrin

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100 Translational Medicine associated with Icodextrin

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100 Patents (Medical) associated with Icodextrin

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565

Literatures (Medical) associated with Icodextrin

01 Jan 2024·Seminars in dialysisQ3 · MEDICINE

Peritoneal dialysis fluids

Q3 · MEDICINE

Article

Author: Liew, Adrian ; Low, Sanmay

Abstract:

There have been significant advances in the understanding of peritoneal dialysis (PD) in the last 40 years, and uptake of PD as a modality of kidney replacement therapy is increasing worldwide. PD fluids, therefore, remains the lifeline for patients on this treatment. Developing these fluids to be efficacious in solute clearance and ultrafiltration, with minimal adverse consequences to peritoneal membrane health and systemic effects is a key requirement. Since the first PD fluid produced in 1959, modifications to PD fluids have been made. Nonetheless, the search for that ideal PD fluid remains elusive. Understanding the components of PD fluids is a key aspect of optimizing the successful delivery of PD, allowing for individualized PD prescription. Glucose remains an integral component of PD fluids; however, its deleterious effects continue to be the impetus for the search of an alternative osmotic agent, and icodextrin remains the main alternative. More biocompatible PD fluids have been developed and have shown benefits in preserving residual kidney function. However, high cost and reduced accessibility remain deterrents to its widespread clinical use in many countries. Large‐scale clinical trials are necessary and very much awaited to improve the narrow spectrum of PD fluids available for clinical use.

30 Nov 2023·Clinical kidney journal

Impact of peritoneal dialysis strategy on technique and patient survival

Article

Author: Astudillo, Elena ; Bueno, Carmen Merino ; Rodríguez-Suárez, Carmen ; Ulloa, Catalina ; Sanchez, Jose Emilio

ABSTRACT:

Background:

The aim of this study was to evaluate the impact of peritoneal dialysis (PD) strategy on technique and patient survival.

Methods:

This was a retrospective, single-center study conducted on consecutive patients with chronic kidney disease who underwent PD between January 2009 and December 2019. The study sample was stratified into four different groups according to PD technique [automated (APD) or manual (CAPD)] and icodextrin use (yes versus no). The primary endpoints were survival of both technique and patient.

Results:

A total of 531 patients were included in the analysis. Mean ± standard deviation age was 60.6 ± 14.6 years, 68.4% (363) were men and 34.8% (185) had diabetes. The median technique survival time was 19 (15) months. A total of 185 (34.8%), 96 (18.1%), 99 (18.7%) and 151 (28.4%) patients were included in the CAPD/No-Icodextrin, CAPD/Icodextrin, APD/No-Icodextrin and APD/Icodextrin study groups, respectively. Throughout the study, 180 (33.9%) patients underwent renal transplant, 71 (13.4%) were changed to hemodialysis and 151 (28.4%) died. Age [hazard ratio (HR) 0.975, 95% confidence interval (CI) 0.960–0.990, P = .001] and incidence of early peritoneal infection (HR 2.440, 95% CI 1.453–4.098, P = .001) were associated with technique survival, while age (HR 1.029, 95% CI 1.013–1.045, P < .001), Charlson Index (HR 1.192, 95% CI 1.097–1.295, P < 0.001), use of icodextrin (HR 0.421, 95% CI 0.247–0.710, P < .001) and APD/Icodextrin (HR 0.499, 95% CI 0.322–0.803, P = .005) were associated with patient survival.

Conclusions:

Icodextrin use and APD/Icodextrin had a positive impact on patient survival, while older age and higher Charlson Index had a negative one. Age and incidence of early peritoneal infection significantly impacted on technique survival.

01 Nov 2023·Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis

Stability and compatibility of intraperitoneal antimicrobials in peritoneal dialysate solutions

Review

Author: Lewis, Susan J ; Alves, Brandon ; Ratnam, Shobha ; Churchwell, Mariann D

To optimise antimicrobial administration in patients with peritoneal dialysis (PD)-related peritonitis, healthcare providers need literature-based information to develop patient-centred pharmacotherapeutic plans. Traditional PD solutions promote osmosis using dextrose or icodextrin with a lactate buffer. Newer PD solutions have modified the osmotic vehicle and buffer. Knowledge of antimicrobial compatibility and stability with newer PD solutions will assist with determining the route of antimicrobial administration as compatible and stable solutions could be delivered directly to the peritoneum using intraperitoneal administration. This review updates the compatibility and stability of antimicrobial additives in newer PD solutions for PD-related peritonitis.

100 Deals associated with Icodextrin

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External Link

KEGG	Wiki	ATC	Drug Bank
D03266	Icodextrin	V07AB	DB00702

R&D Status

Approved

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Indication	Country/Location	Organization	Date
Kidney Diseases	JP	-	29 Nov 2003
Kidney Failure, Chronic	-	Baxter International, Inc.	01 Jan 1994

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Heart Failure	Phase 2	US	Baxter Healthcare Corp.	01 Aug 2006
Heart Failure	Phase 2	AU	Baxter Healthcare Corp.	01 Aug 2006
Heart Failure	Phase 2	BE	Baxter Healthcare Corp.	01 Aug 2006
Heart Failure	Phase 2	CA	Baxter Healthcare Corp.	01 Aug 2006

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


ERA2023	Not Applicable	-	11	Icodextrin-based solution	aarlybrxrd(ldgdqwlrwd) = qyzrqtxyex lnrxkyzjtv (hejflgpxkl ) View more	-	15 Jun 2023
ASN2022	Not Applicable	-	-	Icodextrin	rjvymjdvdg(vniwmzkcya) = qbbqxfxhtg zfqixvvwbh (zymorshjwk, 1.2) View more	-	04 Nov 2022
ERA2020	Not Applicable	-	8	Icodextrin	pcnupvlnvp(vnwwcbfbuu) = elgirhrfmt sgsotungpv (qzgfjkwtlp, 27) View more	Positive	06 Jun 2020
				Icodextrin	pcnupvlnvp(vnwwcbfbuu) = ekovcunwwa sgsotungpv (qzgfjkwtlp, 34) View more
SP503 (ERA2019)	Not Applicable	-	531	Icodextrin	cwlkrxzuny(mzebnjtths): HR = 0.499 (95% CI, 0.331 - 0.752), P-Value = 0.001	Positive	13 Jun 2019
				Icodextrin
ERA2019	Not Applicable	-	-	ICODEXTRIN	gwelcvkrmj(xqsuxwomlp) = kpprkdbacf mhcccgtoec (tidcmkdopf )	-	13 Jun 2019
				ICODEXTRIN	gwelcvkrmj(xqsuxwomlp) = fyjhuthznu mhcccgtoec (tidcmkdopf )
ASN2018	Not Applicable	Hyponatremia	98	Icodextrin	qlezsgvsfd(xucwaqpwvq): OR = 1.88, P-Value = 0.01	Positive	23 Oct 2018
				Icodextrin
ISRCTN14931270 (Pubmed \| BMC Nephrol)	Not Applicable	-	43	Icodextrin solution	tuauuaxhfe(gzgyzjnfjx) = rshiertvxf xhyzrzbfio (enpjwbdfds )	-	08 May 2018
				Glucose-based solution	epwolacefx(qbfeudyzul) = jgxargcndn mknunymhyd (chjbbdexvd ) View more
ASN2017	Not Applicable	-	15	Icodextrin	abfcxmazbi(adtzipewnc): P-Value = 0.448 View more	Positive	31 Oct 2017
				Uni-PET with preceding 7.5% icodextrin long nocturnal dwell
NCT02318888 (ADEPT, Pubmed \| Colorectal Dis)	Not Applicable	Small intestine obstruction	300	icodextrin (Standard surgery)	vgrhtdapwl(gocdwoaptx) = fnvemelyqv igbrailzgj (jbpvvxeqyb )	-	01 Mar 2016
				Standard surgery with icodextrin instillation	vgrhtdapwl(gocdwoaptx) = xjitiimrtb igbrailzgj (jbpvvxeqyb )
ASN2014	Not Applicable	-	86	Icodextrin	indpukobwg(mrqtrldkrh) = rnfbglqpmy isgwjwjvob (qfaypupujh )	Negative	11 Nov 2014
				Dextrose based PD solutions	indpukobwg(mrqtrldkrh) = rscxusmdje isgwjwjvob (qfaypupujh )