In PD, when is icodextrin particularly beneficial?

• A. It provides longer-lasting ultrafiltration during long dwells, reducing glucose exposure.
• B. It reduces blood glucose.
• C. It is used to prevent peritonitis.
• D. It replaces the need for dialysate entirely.

Answer: (D)

Icodextrin works as a long-lasting osmotic agent. In a long dwell, it stays in the peritoneal cavity longer and continues drawing water into the dialysate, providing sustained ultrafiltration. This is especially helpful for patients who need more UF during extended dwell times or who absorb a lot of glucose from standard dextrose solutions, because icodextrin allows for effective fluid removal with less glucose exposure overall. It does not replace dialysate entirely—dialysate is still used, just with icodextrin as the osmotic agent—and it isn’t a measure to prevent peritonitis. It also isn’t used primarily to lower blood glucose, though reducing glucose exposure is a beneficial side effect.