Analysis of ultrafiltration volume during long dwell with icodextrin in automated peritoneal dialysis

Icodextrin's unique osmotic properties enable effective fluid volume management in the peritoneal cavity by limiting reabsorption. However, its efficacy fluctuates during prolonged dwell periods in automated peritoneal dialysis (APD), posing challenges and increasing the risk of treatment failu...

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Main Authors: Tara Srouji, Antoine Lanot, Clémence Béchade, Thierry Lobbedez, Annabel Boyer
Format: Article
Language:English
Published: RDPLF 2025-03-01
Series:Bulletin de la Dialyse à Domicile
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Online Access:https://bdd.rdplf.org/index.php/bdd/article/view/86303
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author Tara Srouji
Antoine Lanot
Clémence Béchade
Thierry Lobbedez
Annabel Boyer
author_facet Tara Srouji
Antoine Lanot
Clémence Béchade
Thierry Lobbedez
Annabel Boyer
author_sort Tara Srouji
collection DOAJ
description Icodextrin's unique osmotic properties enable effective fluid volume management in the peritoneal cavity by limiting reabsorption. However, its efficacy fluctuates during prolonged dwell periods in automated peritoneal dialysis (APD), posing challenges and increasing the risk of treatment failure. This study examines negative ultrafiltration (UF) during daytime dwell in APD patients using icodextrin and aims to identify associated factors. A retrospective observational monocentric study on UF during prolonged icodextrin dwell periods in APD was conducted among 27 incident patients at the University Hospital of Caen in Normandy, France. The primary focus was the presence of negative daytime UF, with intraperitoneal pressure (IPP) as the main exposure variable. Statistical analyses, including group comparisons and univariate and multivariate logistic regressions, explored associations between negative daytime UF, IPP, and other relevant variables. While no variable showed a significant correlation, IPP (OR=1.06), Volume of the last injection (OR=0.97), and Body Mass Index (OR=0.97) exhibited interesting trends. The multivariate analysis showed no significant association between the variables and negative daytime UF. Nevertheless, IPP was the only variable that improved the model's quality, suggesting a potential link for further exploration. This study raises important questions for future research and clinical practice regarding the systematic measure of the IPP during peritoneal dialysis treatments, despite its limitations, including a small sample size and the retrospective observational nature of the methodology, affecting the statistical power and the ability to establish causal links.
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spelling doaj-art-ac2a873d0db649edb5f23fd4919f20822025-08-20T03:40:34ZengRDPLFBulletin de la Dialyse à Domicile2607-99172025-03-018110.25796/bdd.v8i1.86303Analysis of ultrafiltration volume during long dwell with icodextrin in automated peritoneal dialysisTara Srouji0Antoine Lanot1Clémence Béchade2Thierry Lobbedez3Annabel Boyer4Normandie Université, Unicaen, UFR des Sciences Pharmaceutiques, Bd Henri Becquerel, 14032 Caen Cedex, FranceU1086 INSERM – ANTICIPE – Centre Régional de Lutte Contre le Cancer, François Baclesse, Caen, France Normandie Université, Unicaen, UFR de Médecine, 2 rue des Rochambelles, 14032 Caen Cedex, France3U1086 INSERM – ANTICIPE – Centre Régional de Lutte Contre le Cancer, François Baclesse, Caen, France 4Normandie Université, Unicaen, UFR de Médecine, 2 rue des Rochambelles, 14032 Caen Cedex, France3U1086 INSERM – ANTICIPE – Centre Régional de Lutte Contre le Cancer, François Baclesse, Caen, France 4Normandie Université, Unicaen, UFR de Médecine, 2 rue des Rochambelles, 14032 Caen Cedex, France2Centre Universitaire des Maladies Rénales, CHU de Caen, 14 033 Caen Cedex 9, France 3U1086 INSERM – ANTICIPE – Centre Régional de Lutte Contre le Cancer, François Baclesse, Caen, FranceIcodextrin's unique osmotic properties enable effective fluid volume management in the peritoneal cavity by limiting reabsorption. However, its efficacy fluctuates during prolonged dwell periods in automated peritoneal dialysis (APD), posing challenges and increasing the risk of treatment failure. This study examines negative ultrafiltration (UF) during daytime dwell in APD patients using icodextrin and aims to identify associated factors. A retrospective observational monocentric study on UF during prolonged icodextrin dwell periods in APD was conducted among 27 incident patients at the University Hospital of Caen in Normandy, France. The primary focus was the presence of negative daytime UF, with intraperitoneal pressure (IPP) as the main exposure variable. Statistical analyses, including group comparisons and univariate and multivariate logistic regressions, explored associations between negative daytime UF, IPP, and other relevant variables. While no variable showed a significant correlation, IPP (OR=1.06), Volume of the last injection (OR=0.97), and Body Mass Index (OR=0.97) exhibited interesting trends. The multivariate analysis showed no significant association between the variables and negative daytime UF. Nevertheless, IPP was the only variable that improved the model's quality, suggesting a potential link for further exploration. This study raises important questions for future research and clinical practice regarding the systematic measure of the IPP during peritoneal dialysis treatments, despite its limitations, including a small sample size and the retrospective observational nature of the methodology, affecting the statistical power and the ability to establish causal links. https://bdd.rdplf.org/index.php/bdd/article/view/86303Peritoneal DialysisAutomated Peritoneal DialysisChronic Kidney DiseaseIcodextrinIntra-Peritoneal PressureUltrafiltration
spellingShingle Tara Srouji
Antoine Lanot
Clémence Béchade
Thierry Lobbedez
Annabel Boyer
Analysis of ultrafiltration volume during long dwell with icodextrin in automated peritoneal dialysis
Bulletin de la Dialyse à Domicile
Peritoneal Dialysis
Automated Peritoneal Dialysis
Chronic Kidney Disease
Icodextrin
Intra-Peritoneal Pressure
Ultrafiltration
title Analysis of ultrafiltration volume during long dwell with icodextrin in automated peritoneal dialysis
title_full Analysis of ultrafiltration volume during long dwell with icodextrin in automated peritoneal dialysis
title_fullStr Analysis of ultrafiltration volume during long dwell with icodextrin in automated peritoneal dialysis
title_full_unstemmed Analysis of ultrafiltration volume during long dwell with icodextrin in automated peritoneal dialysis
title_short Analysis of ultrafiltration volume during long dwell with icodextrin in automated peritoneal dialysis
title_sort analysis of ultrafiltration volume during long dwell with icodextrin in automated peritoneal dialysis
topic Peritoneal Dialysis
Automated Peritoneal Dialysis
Chronic Kidney Disease
Icodextrin
Intra-Peritoneal Pressure
Ultrafiltration
url https://bdd.rdplf.org/index.php/bdd/article/view/86303
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