Impact of icodextrin on ventricular hyperthrophy in patients with chronic kidney disease on peritoneal dialysis

• Grant number: 16/18798-7
• Support Opportunities: Regular Research Grants
• Start date: July 01, 2017
• End date: December 31, 2019
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Rosilene Motta Elias Coelho
• Grantee: Rosilene Motta Elias Coelho
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated researchers: Maria Eugênia Fernandes Canziani ; Rosa Maria Affonso Moysés

Abstract

Chronic Kidney Disease (CKD) is increasing worldwide. Cardiovascular is the main cause mortality in CKD. Left ventricular hypertrophy (LVH) is a risk factor for cardiovascular death and is often found in this population. To minimize LVH is necessary to control blood pressure, extracellular volume, diabetes mellitus, dyslipidemia and especially in patients with CKD, control of mineral and bone metabolism disorders (CKD-MBD). The fluid overload is the main responsible to LVH and it is a limiting factor for Peritoneal Dialysis (PD). In order to control hypervolemia in PD, icodextrin, which is a peritoneal solution of high osmotic, is a good therapeutic option. Indeed, icodextrin is worldwide used for ultrafiltration optimization. Some studies have obtained encouraging results after using this solution. One study showed that within four months of icodextrin use, it was a reduction of LVH as measure by echocardiography. Higher phosphorus clearance has also been related to the action of icodextrin in reducing LVH. Whether the reduction of LVH is due to control of hypervolemia or higher phosphorus clearance is still debatable. In addition, echocardiogram is not the most appropriate method to address LVH among patients on dialysis. The aim of the present study is to analyze the LVH after the use of icodextrin, in a randomized trial comparing icodextrin with a standard glucose solution. In addition, we intend to confirm previous results of ventricular mass reduction using heart magnetic resonance image, which is considered a gold standard technique to evaluate LVH. (AU)