Peritoneal Transport after Long-Term Exposure to Icodextrin in Rats

Abstract

Background: Icodextrin, an effective osmotic substance that has been proposed as an alternative agent for peritoneal dialysis induces ultrafiltration over long dwells. This study examines the peritoneal transport after exposure to Icodextrin in rats. Methods: Animals were divided in 4 groups and injected daily for 30 days with Icodextrin 7.5 % (n = 14), Glucose 4.25 % (n = 19) or glucose 4.25% plus Icodextrin 7.5 % (n = 13). Rats of the control group (n = 15) were not exposed. A 4-hour permeability study was performed using glucose at days 1, 30 and 60. At days 2, 31 and 61 the same animals were injected with Icodextrin. Results: Slopes of effluent sodium at day 30 were significantly higher (p < 0.001) in the glucose (0.006 ± 0.016), Icodextrin (0.013 ± 0.014) and mixed groups (0.012 ± 0.017) than in the control group (–0.041 ± 0.021). Urea D/P ratio was not significantly different in the 4 groups. After 30 days, glucose effluent levels were significantly lower (p < 0.001) in the glucose (701 ± 278 mg/dl), Icodextrin (552 ± 209 mg/dl) and mixed groups (587 ± 344 mg/dl) than in control rats (1519 ± 413 mg/dl). Effluent protein (mg/l) in the mixed group (1,555 ± 357) was significantly higher (p < 0.001) than control (376 ± 33), glucose (1,015 ± 232) and Icodextrin (765 ± 75) groups at day 30. Conclusion: The long-term use of Icodextrin does not affect small molecule transport, but induces changes in the peritoneal protein excretion, especially when Icodextrin and glucose are injected together.