Effects of icodextrin on glycemic and lipid profiles in diabetic patients undergoing peritoneal dialysis

Am J Nephrol. 2007;27(4):409-15. doi: 10.1159/000105123. Epub 2007 Jul 3.


Aim: Icodextrin reduces glucose absorption from the peritoneal dialysate. We conducted this prospective, open-labeled, multicenter study to determine the effects of icodextrin on glycemic and lipid parameters in diabetic patients undergoing continuous ambulatory peritoneal dialysis (PD) or automated PD.

Methods: Patients were recruited from 15 institutions in Japan, and a total of 51 patients (15 women and 36 men, mean age: 59 +/- 10 years, median duration of PD: 13 months) were enrolled. The patients were administered an overnight or daytime dwell of 1.5 or 2.0 l of 7.5% icodextrin-containing solution. At baseline and 3, 6, 9 and 12 months after the start of icodextrin, nonfasting blood was drawn for measurement of glycated hemoglobin (HbA1C) and serum lipids.

Results: During icodextrin treatment, there was no change in overall HbA1C levels compared to baseline values; however, for those with baseline HbA1C > or =6.5% (n = 22), significant decreases in HbA1C were observed. Mean total/LDL cholesterol and triglycerides were decreased significantly during icodextrin treatment, with greater decreases for patients with baseline total cholesterol > or =220 mg/dl, LDL cholesterol > or =120 mg/dl or triglycerides > or =150 mg/dl. HDL cholesterol did not differ at any time point; however, values for patients with baseline HDL cholesterol <40 mg/dl tended to increase with marginal significance.

Conclusions: In the current study, switching from glucose-containing dialysis solution to icodextrin resulted in improved lipid profiles and possibly a favorable metabolic profile, particularly in patients with poor glycemic control. These hypotheses remain to be proven in controlled clinical trials.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carbohydrate Metabolism / drug effects*
  • Diabetic Nephropathies / therapy*
  • Dialysis Solutions / adverse effects
  • Dialysis Solutions / pharmacology
  • Dialysis Solutions / therapeutic use*
  • Female
  • Glucans / adverse effects
  • Glucans / pharmacology
  • Glucans / therapeutic use*
  • Glucose / adverse effects
  • Glucose / pharmacology
  • Glucose / therapeutic use*
  • Humans
  • Icodextrin
  • Lipid Metabolism / drug effects*
  • Male
  • Middle Aged
  • Peritoneal Dialysis, Continuous Ambulatory


  • Dialysis Solutions
  • Glucans
  • Icodextrin
  • Glucose