Icodextrin is Associated with a Lower Risk of Stroke in Peritoneal Dialysis Patients

Nephron. 2019;141(2):112-118. doi: 10.1159/000494511. Epub 2018 Nov 13.

Abstract

Background/aims: This study investigated whether peritoneal dialysis (PD) patients using icodextrin were at a reduced risk of stroke.

Methods: From Taiwan National Health Insurance data, it was found that there were 6,796 new end-stage renal disease patients undergoing dialysis between 2005 and 2011. We compared the risk of stroke between PD patients with or without icodextrin treatment. The follow-up period began from the date of PD initiation to the end of 2011. The time-dependent Cox proportional hazards regression models were used to analyze the risk of stroke.

Results: Among PD patients, the icodextrin users had both a lower incidence and risk of stroke than icodextrin non-users (incidence: 22.4 vs. 25.2/1,000 person-years) with an adjusted hazard ratio of 0.76 (95% CI 0.63-0.93). The results were similar in models considering death a competing risk (overall: adjusted subhazard ratio [SHR] 0.78, 95% CI 0.63-0.94). Icodextrin users also had a lower risk of ischemic stroke with or without considering death a competing risk (adjusted SHR 0.71, 95% CI 0.57-0.89 and adjusted HR 0.74, 95% CI 0.59-0.93, respectively), compared to non-users.

Conclusion: The use of icodextrin is associated with a lower incidence and risk of stroke in PD patients.

Keywords: Icodextrin; Peritoneal dialysis; Stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Dialysis Solutions / adverse effects*
  • Female
  • Humans
  • Icodextrin / adverse effects*
  • Incidence
  • Middle Aged
  • Peritoneal Dialysis / adverse effects*
  • Proportional Hazards Models
  • Risk Factors
  • Risk Reduction Behavior
  • Stroke / etiology*
  • Taiwan

Substances

  • Dialysis Solutions
  • Icodextrin