When and how should icodextrin be used in PD?

When and how should icodextrin be used in PD?

• A. For short dwells to provide rapid ultrafiltration.
• B. For long dwells to provide sustained ultrafiltration, especially in high transport patients; used in CCPD or extended daytime dwells per prescription.
• C. Only for use in hemodialysis.
• D. Never used.

Answer: (B)

Icodextrin provides sustained ultrafiltration during long dwell times because its osmotic gradient remains active much longer than glucose-based solutions. This makes it especially helpful for high transport peritoneal membranes, where the UF effect from glucose solutions tends to dissipate during a lengthy exchange. By staying in the cavity longer, icodextrin keeps drawing water out over extended periods, enabling effective fluid removal. Therefore, it is used for long dwells—such as extended daytime exchanges or overnight CCPD—per the prescription, to maintain ultrafiltration when a longer, steadier UF is needed. It is not suited for short-duration dwells, where the UF effect would be insufficient, and it isn’t used in hemodialysis.

Icodextrin provides sustained ultrafiltration during long dwell times because its osmotic gradient remains active much longer than glucose-based solutions. This makes it especially helpful for high transport peritoneal membranes, where the UF effect from glucose solutions tends to dissipate during a lengthy exchange. By staying in the cavity longer, icodextrin keeps drawing water out over extended periods, enabling effective fluid removal.

Therefore, it is used for long dwells—such as extended daytime exchanges or overnight CCPD—per the prescription, to maintain ultrafiltration when a longer, steadier UF is needed. It is not suited for short-duration dwells, where the UF effect would be insufficient, and it isn’t used in hemodialysis.