Icodextrin: Overview of Clinical Experience

Objective To review all clinical studies and experience gained with icodextrin to date; primarily its use in peritoneal dialysis in patients with end-stage renal failure, but also its use as an intraperitoneal vehicle. Data sources Peer-reviewed original research articles in the literature; abstracts from international scientific meetings; data generated from the compassionate use programme. Study selection All published studies to date are included, some 10–20 studies being included in this review. Data extraction Data have not been specifically extracted from studies; results have been described in the context of overall experience. Results Over ten years of clinical experience with icodextrin have now been accumulated, in both continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD). A small number of patients have received icodextrin for over five years, with no loss of effect. Icodextrin produces sustained ultrafiltration over long dwells while being iso-osmolar, by the process of colloid osmosis. Conclusion Icodextrin represents the first viable alternative osmotic agent to glucose, for use in solutions for peritoneal dialysis. It also has a potential use as a vehicle solution for intraperitoneal drug delivery.