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Nephrol Dial Transplant (2003) 18: 2482-2485
© 2003 European Renal Association-European Dialysis and Transplant Association

Editorial Comment

Icodextrin-associated peritonitis: what conclusions thus far?

Eric Goffin1, Jean-Pierre Cosyns2, Françoise Pirson3 and Olivier Devuyst1

1Division of Nephrology, 2Division of Pathology and 3Division of Pneumology, Université Catholique de Louvain Medical School, Brussels, Belgium

Correspondence and offprint requests to: Eric Goffin, MD, Division of Nephrology, Université Catholique de Louvain Medical School, 10 Avenue Hippocrate, B-1200 Brussels, Belgium. Email: goffin@nefr.ucl.ac.be

Keywords: allergy; hypersensitivity; icodextrin; peritonitis; peritoneal dialysis; peptidoglycan

The first 150 words of the full text of this article appear below.



   Introduction
 
Icodextrin 7.5% (Extraneal; Baxter Healthcare, McGaw Park, IL, USA) is an iso-osmolar formulation of maltodextrin glucose polymer derived from starch that is increasingly used to enhance ultrafiltration during long dwells in continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD) patients [1–3]. Since its introduction in the UK in 1994, icodextrin has been used in more than 23 000 patients in many parts of the world [4]. Except for rare cutaneous hypersensitivity reactions [5,6], icodextrin is generally safe and well tolerated. Within the last 3 years, however, several reports of sterile chemical peritonitis have been attributed to icodextrin prescription [7–19]. In this comment, we will briefly review the clinical and physiopathological aspects of this syndrome.



   Clinical presentation of icodextrin-associated peritonitis
 
Typically, peritoneal dialysis (PD) patients with icodextrin-associated sterile peritonitis are admitted with abdominal discomfort and cloudy dialysate effluents. No associated . . . [Full Text of this Article]



   What is the prevalence of the syndrome?
 


   What are the consequences?
 


   What is the cause of this syndrome?
 


   Unanswered questions
 


   Conclusions and recommendations
 

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