Delving into the Latest Updates on Icodextrin with Synapse

The study aims to provide the pharmacokinetics profiles of single- and double-dose icodextrin in patients on peritoneal dialysis (PD). It may expand the available knowledge of the clinical pharmacology of icodextrin following its intraperitoneal administration and fills the gaps in our understanding of the fate of icodextrin and the metabolic consequences of icodextrin and its metabolites.

Start Date15 Aug 2024

Sponsor / Collaborator

Peking University First Hospital

NCT06492031 / RecruitingNot Applicable

Effectiveness and Safety of Icodextrin Peritoneal Dialysis Solution (Extraneal®) for Long Dwell Exchange in Peritoneal Dialysis in Patients With Chronic Renal Failure: a Multicenter, Ambispective Cohort, Observational, Real-world Study

The purpose of this study is to evaluate the effectiveness and safety of icodextrin and glucose peritoneal dialysis (PD) solutions for the long dwell exchange in PD patients with continuous ambulatory peritoneal dialysis (CAPD), and to describe medical resource utilization in patients with PD on icodextrin.

Start Date28 Jun 2024

Sponsor / Collaborator

Baxter Healthcare Ltd

NCT05943470 / Not yet recruitingPhase 4IIT

The Difference Between Daily and Alternative Day Use of Icodextrin in Peritoneal Dialysis

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

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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577

Literatures (Medical) associated with Icodextrin

01 Sep 2024·Artificial Organs

Oxidative stress reduction by icodextrin‐based glucose‐free solutions in peritoneal dialysis: Support for new promising approaches

Article

Author: Bertoldi, Giovanni ; Calò, Lorenzo A ; Bettin, Elisabetta ; Baldini, Paola ; Basso, Anna ; Cacciapuoti, Martina ; Caputo, Ilaria ; Driussi, Giulia

AbstractBackgroundOxidative stress (OxSt) and inflammation are common in CKD and are known CV and mortality risk factors. In peritoneal dialysis (PD) OxSt and Inflammation even increase due to the use of glucose‐based solutions.Patients and MethodsThis study analyzed in 15 PD patients the effect of 3 and 6 months of treatment with icodextrin‐based glucose‐free solutions on OxSt and inflammation, evaluating p22phox protein expression (Western blot), NADPH oxidase subunit, essential for OxSt activation, MYPT‐1 phosphorylation state, marker of RhoA/Rho kinase pathway (ROCK) activity, involved in the induction of OxSt (Western blot) and Malondialdehyde (MDA) production (fluorimetric assay). Interleukin (IL)‐6 blood level (chemiluminescence assay) has been measured and used as a marker of inflammation.Resultsp22phox protein expression, MYPT 1 phosphorylation, and MDA were reduced after 3 months from the start of icodextrin (1.28 ± 0.18 d.u. vs. 1.50 ± 0.19, p = 0.049; 0.89 ± 0.03 vs. 0.98 ± 0.03, p = 0.004; 4.20 ± 0.18 nmol/mL vs. 4.84 ± 0.32 nmol/mL, p = 0.045, respectively). In a subgroup of 9 patients who continued the treatment up to 6 months, MYPT‐1 phosphorylation was further reduced at 6 months compared to baseline (0.84 ± 0.06 vs. 0.99 ± 0.04, p = 0.043), while p22phox protein expression was reduced only at 6 months versus baseline (1.03 ± 0.05 vs. 1.68 ± 0.22, p = 0.021). In this subgroup, MDA was reduced at 6 months versus baseline (4.03 ± 0.24 nmol/mL vs. 4.68 ± 0,32, p = 0.024) and also versus 3 months (4.03 ± 0.24 vs. 4.35 ± 0.21, p = 0.008). IL‐6 level although reduced both at 3 and 6 months, did not reach statistical significance.ConclusionsThe reduction of OxSt with icodextrin‐based PD solutions, although obtained in a small patients cohort and in a limited time duration study, strongly supports the rationale of using osmo‐metabolic agents‐based fluids replacing glucose‐based fluids. Ongoing studies with these agents will provide information regarding preservation of peritoneal membrane integrity, residual renal function, and reduction of CVD risk factors such as OxSt and inflammation.

01 Jul 2024·Nephrology

Icodextrin‐induced acute generalized exanthematous pustulosis in a patient with peritoneal dialysis

Article

Author: Sung, Chih-Chien ; Liu, Chun-Hao ; Chen, Chien-Chou

AbstractIcodextrin has been widely prescribed for peritoneal dialysis (PD) patients with inadequate ultrafiltration, but icodextrin induced acute generalized exanthematous pustulosis (AGEP) has been not well recognized in clinical practice. We described a young‐aged female with IgA nephropathy and end stage kidney disease under continuous automated peritoneal dialysis. She developed skin erythema with exfoliation over the groin 7th day after initiation of icodextrin based PD dialysate. Initially, her scaling skin lesion with pinhead‐sized pustules affected the bilateral inguinal folds, and then it extended to general trunk accompanied by pruritus. She was admitted because of deterioration of skin lesion on 14th day of icodextrin exposure. She was afebrile and physical examination was notable for widespread erythematous papules with pruritus extending over her groins and trunk. Pertinent laboratory examination showed leukocytosis of 18 970 cells/μL with neutrophile count of 17 642 cells/μL (92.3%), and c‐reactive‐protein: 3.39 mg/dL. Skin biopsy revealed multifocal sub corneal abscess with papillary dermal edema, and upper‐dermal neutrophilia with perivascular accentuation, consistent with the diagnosis of AGEP. After discontinuation of PD, she underwent temporary high‐flux haemodialysis with treatment of steroid and antihistamine. Her dermatologic lesion resolved without any skin sequalae completely within 4 days, and she underwent icodextrin‐free peritoneal dialysis at 17th day. This case highlighted the fact that icodextrin‐induced AGEP should be early recognized to avoid inappropriate management.

01 May 2024·Artificial Organs

Differential effects of biocompatible peritoneal dialysis fluids on human mesothelial and endothelial cells in 2D and 3D phenotypes

Article

Author: Bartosova, Maria ; Pitaraki, Eleanna ; Liakopoulos, Vassilios ; Papazoglou, Eleftherios D ; Schmitt, Claus Peter ; Zarogiannis, Sotirios G ; Zebekakis, Pantelis ; Rouka, Erasmia ; Jagirdar, Rajesh M

AbstractIntroductionPeritoneal dialysis (PD) is a life maintaining treatment in patients with end‐stage renal disease. Its chronic application leads to peritoneal mesothelial layer denudation and fibrotic transformation along with vascular activation of inflammatory pathways. The impact of different PD fluids (PDF) on mesothelial and endothelial cell function and repair mechanisms are not comprehensively described.Materials and MethodsMesothelial (MeT‐5A) and endothelial cells (EA.hy926) were cultured in 1:1 ratio with cell medium and different PDF (icodextrin‐based, amino acid‐based, and glucose‐based). Cell adhesion, cell migration, and cell proliferation in 2D and spheroid formation and collagen gel contraction assays in 3D cell cultures were performed.ResultsCell proliferation and cell‐mediated gel contraction were both significantly decreased in all conditions. 3D spheroid formation was significantly reduced with icodextrin and amino acid PDF, but unchanged with glucose PDF. Adhesion was significantly increased by amino acid PDF in mesothelial cells and decreased by icodextrin and amino acid PDF in endothelial cells. Migration capacity was significantly decreased in mesothelial cells by all three PDF, while endothelial cells remained unaffected.ConclusionsIn 3D phenotypes the effects of PDF are more uniform in both mesothelial and endothelial cells, mitigating spheroid formation and gel contraction. On the contrary, effects on 2D phenotypes are more uniform in the icodextrin and amino acid PDF as opposed to glucose ones and affect mesothelial cells more variably. 2D and 3D comparative assessments of PDF effects on the main peritoneal membrane cell barriers, the mesothelial and endothelial, could provide useful translational information for PD studies.

100 Deals associated with Icodextrin

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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	AU	Baxter Healthcare Corp.	01 Aug 2006
Heart Failure	Preclinical	US	Baxter Healthcare Corp.	01 Aug 2006
Heart Failure	Preclinical	CA	Baxter Healthcare Corp.	01 Aug 2006
Heart Failure	Preclinical	BE	Baxter Healthcare Corp.	01 Aug 2006
Hypertriglyceridemia	Discovery	KR	Takeda Pharmaceutical Co., Ltd.	-

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Clinical Result

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


ASN2022	Not Applicable	-	-	Icodextrin	(weofjujfhr) = ajgulwsrxw icyiqfapau (oyxofitjmz, 1.2) View more	-	04 Nov 2022
ERA2020	Not Applicable	-	8	Icodextrin	whbehiysjc(jkhtmthxlf) = kedarosjtj rtrrgzomuu (boqwmjqdkt, 27) View more	Positive	06 Jun 2020
				Icodextrin	whbehiysjc(jkhtmthxlf) = dzamvkadtk rtrrgzomuu (boqwmjqdkt, 34) View more
SP503 (ERA2019)	Not Applicable	-	531	Icodextrin	(qvjojxbsyy): HR = 0.499 (95% CI, 0.331 - 0.752), P-Value = 0.001	Positive	13 Jun 2019
				Icodextrin
ERA2019	Not Applicable	Pleural Effusion	-	ICODEXTRIN	mmkfprhdic(ynldcjaewq) = evtdgwrdio myspizhxfb (lfnwgghqxn )	-	13 Jun 2019
				ICODEXTRIN	mmkfprhdic(ynldcjaewq) = eqdczxshua myspizhxfb (lfnwgghqxn )
ASN2018	Not Applicable	Hyponatremia	98	Icodextrin	(hniobufyqa): OR = 1.88, P-Value = 0.01	Positive	23 Oct 2018
				Icodextrin
ISRCTN14931270 (Pubmed \| BMC Nephrol)	Not Applicable	-	43	Icodextrin solution	qbkztxdeli(wiuvkhlzlh) = hnbbqsmdkz mgsbtstqmj (bagzxjvguv )	-	08 May 2018
				Glucose-based solution	crwgtibcht(jizdvhnzij) = upyfhmsuwa kxzcfjmadq (hzlythiyln ) View more
ASN2017	Not Applicable	-	15	Icodextrin	fnnantcinb(gjwjaazvon): 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)	flkhjvevwz(klxbssmjuz) = skcehwljqh elirruyluy (eoecchekwb )	-	01 Mar 2016
				Standard surgery with icodextrin instillation	flkhjvevwz(klxbssmjuz) = ocuilouokb elirruyluy (eoecchekwb )
ASN2014	Not Applicable	-	86	Icodextrin	nhfpgxabpx(dsscbyrkvw) = whekedoqqr jcvetpsojr (kymheefvnb )	Negative	11 Nov 2014
				Dextrose based PD solutions	nhfpgxabpx(dsscbyrkvw) = qtwaufyyxp jcvetpsojr (kymheefvnb )
Taiwan National Health Insurance Research Database (ASN2014)	Not Applicable	high transporters \| high-glucose containing dialysates	1,627	Icodextrin	jszlwkeemx(zerbvzveub): HR = 0.6 (95% CI, 0.37 - 0.99), P-Value = 0.045	Positive	11 Nov 2014
				Non-Icodextrin