Metabolic and laboratory effects of icodextrin

As shown in Table 4 the use of icodextrin based peritoneal dialysis fluid for the long dwell in PD patients is associated with metabolic and laboratory effects, which are different than those observed for dextrose-based solutions. Apart from the retention of icodextrin metabolites in plasma, the metabolic effects of icodextrin are in general less conspicuous than those of dextrose solutions. Although icodextrin is a polymer of glucose molecules, its higher molecular weight, slower absorption from the peritoneal cavity and gradual metabolism by serum amylase prevent the hyperglycemia, hyperinsulinemia and other metabolic effects that are associated with hypertonic dextrose solutions. The temporal profile of the peritoneal absorption and metabolism of icodextrin thus explains why the metabolic effects of this glucose polymer are distinct from those of glucose itself.