A peritoneal dialysis solution that removes fluid
Icodextrin
A glucose-polymer solution used in peritoneal dialysis to draw fluid out of the body.
What is Icodextrin?
Icodextrin is a solution used in peritoneal dialysis, a type of dialysis done through the lining of the tummy, to draw excess fluid out of the body during a long dwell (such as overnight). Instead of glucose, it uses a glucose polymer that removes fluid steadily over many hours. The most important safety point is that icodextrin causes some home blood-glucose meters to read falsely high; this is dangerous because it can hide a true low blood sugar, so people using it must use glucose-specific meters and test strips. It can occasionally cause sterile peritonitis (inflammation without infection) or skin reactions.
Education and reference only. This is a plain-language guide to Icodextrin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Icodextrin is a peritoneal dialysis solution. In peritoneal dialysis, a fluid is run into the tummy through a soft tube, left to dwell while it draws out waste and excess fluid across the lining of the abdomen, and then drained away. Most dialysis fluids use glucose to pull fluid out, but icodextrin uses a glucose polymer (a larger sugar molecule) that works more slowly and steadily, making it well suited to the long dwell, such as the overnight or daytime long exchange. It is provided and overseen by a kidney (renal) dialysis team.
How it works
Icodextrin draws fluid out of the body across the lining of the tummy by osmosis. Because it uses a larger glucose-polymer molecule that is absorbed only slowly, it keeps pulling fluid out steadily over many hours, which makes it better than ordinary glucose fluid for the single long dwell of the day. An important consequence is that, as the polymer is broken down in the body, it produces a sugar called maltose; this is what confuses some blood-glucose meters, which is why glucose-specific testing must be used to measure blood sugar accurately.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist peritoneal dialysis solution used in the UK to remove fluid during long dwells, particularly the overnight or daytime long exchange.
What it treats
Conditions Icodextrin is used for
Practical use
How to take Icodextrin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Use it for one long dwell a day, such as the overnight or long daytime exchange, exactly as your renal team directs.
- Use only glucose-specific blood-glucose meters and test strips, as icodextrin can make some meters read falsely high.
- Tell any doctor, nurse or hospital, and laboratory staff, that you are using icodextrin, so blood sugar is measured correctly.
- Report cloudy drained fluid, tummy pain or fever promptly, as these can be signs of peritonitis.
- Report any skin rash, which can occasionally occur with icodextrin.
Weighing it up
Advantages & disadvantages of Icodextrin
Advantages
- Removes fluid steadily over a long dwell, making it well suited to the single long exchange of the day.
- Uses a glucose polymer rather than glucose, so it adds less sugar load during that exchange.
- Helps manage fluid balance in people on peritoneal dialysis for kidney failure.
Disadvantages
- Causes some blood-glucose meters to read falsely high, which can dangerously hide a low blood sugar.
- Suited to one long dwell a day rather than frequent exchanges.
- Can occasionally cause sterile peritonitis or skin reactions.
Practical use
Good to know
The single most important thing to know about icodextrin is that it can make some home blood-glucose meters and test strips read falsely high. This is dangerous because a falsely high reading can hide a genuinely low blood sugar (hypoglycaemia), which could then go untreated; for this reason, anyone using icodextrin, and especially anyone with diabetes, must use only glucose-specific meters and strips, and should make sure healthcare staff know they are on icodextrin. It is designed for the long dwell of the day rather than for frequent exchanges. It can occasionally cause sterile peritonitis, which is inflammation of the tummy lining without infection, causing cloudy drained fluid and discomfort that should be reported, as well as skin rashes in some people. The renal team explains how to use it and what to watch for.
Who should not take it / use with caution
- People who have had a serious allergic reaction to icodextrin or to starch-derived (corn) products should not use it.
- It must not be used by people with the rare inherited sugar disorder that prevents them breaking down maltose and isomaltose (glycogen storage disease).
- It is used with care in people who cannot use glucose-specific blood-glucose testing, because of the false-reading risk.
- It is used only as part of a peritoneal dialysis programme overseen by a renal team.
Monitoring
- Using glucose-specific testing to monitor blood sugar accurately, especially in people with diabetes.
- Watching the drained fluid for cloudiness and for tummy pain or fever that could mean peritonitis.
- Reviewing fluid balance, weight and overall dialysis with the renal team.
Side effects
- Falsely high readings on some blood-glucose meters, which can hide a true low blood sugar.
- Skin rashes, which can occasionally occur.
- Sterile peritonitis (inflammation of the tummy lining without infection), causing cloudy drained fluid and discomfort.
- Rarely, more serious allergic-type reactions, which need urgent attention.
Key interactions
- It interferes with certain blood-glucose meters and test strips, so only glucose-specific testing should be used.
- It can affect some laboratory blood tests (such as certain amylase and sugar measurements), so labs should know it is being used.
- Tell your team about all your medicines, including insulin, as accurate blood sugar measurement is essential.
Available as: A solution run into the abdomen through a dialysis tube (catheter).
Answers
Icodextrin: frequently asked questions
What is icodextrin used for?
It is a peritoneal dialysis solution used to draw excess fluid out of the body during a long dwell, such as the overnight exchange, in people on peritoneal dialysis for kidney failure.
Why can it affect my blood-glucose readings?
As icodextrin is broken down it produces a sugar called maltose, which fools some blood-glucose meters into reading falsely high; this can dangerously hide a true low blood sugar, so glucose-specific meters and strips must be used.
Is icodextrin dangerous if I have diabetes?
It is used in people with diabetes, but it is essential to use only glucose-specific meters and strips so that a real low blood sugar is not missed; tell all healthcare staff you are using it.
What is sterile peritonitis?
It is inflammation of the tummy lining without an infection, which can cause cloudy drained fluid and discomfort; report these to your renal team, as they will check what is causing them.
How often is it used?
It is usually used for just one long dwell a day, such as overnight, rather than for frequent exchanges, because it removes fluid slowly and steadily.
Authoritative sources
- BNF
- NICE CKS
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