Icodextrin Fulfills Unmet Clinical Need of PD Patients: Improved Ultrafiltration

Extraneal®, a new peritoneal dialysis solution, was recently approved by the U.S. Food and Drug Administration (FDA) for use during the long dwell of peritoneal dialysis (PD). It represents a new class of osmotic agents with demonstrated clinical advantages over standard dextrose-based solutions, particularly for patients who would benefit from an improvement in ultrafiltration (UF). Studies comparing icodextrin and 2.5% dextrose for the long dwell have consistently demonstrated greater UF with icodextrin. In addition, because the icodextrin solution does not contain dextrose, the daily glucose load and associated risk of metabolic abnormalities are reduced. Icodextrin also has benefits beyond improved UF, including improvement in blood pressure control, fluid balance, and glycemic control, as well as extension of the time patients are able to stay on the therapy. These benefits could allow patients the opportunity to continue on their preferred dialysis modality.