Questions About PD
The UF of icodextrin is sustained over a long period of time up to 12-14 hours, while the UF capacity of 4.25% glucose decreases with time. So with a long dwell, icodextrin solution produces a much better UF than 4.25%.
To use 4.25% overnight is not very advisable, though not contraindicated. First, with a long dwell, the beneficial effect is not so remarkable. Second, the high glucose absorption at night time is not so physiological as patients have low metabolic activity during sleep. Third, at certain time over the dwell, usually 2 – 4 hours after instillation, depending on the peritoneal transport type, the intraperitoneal volume is quite large, some patient may experience discomfort affecting their sleep or breathing.