Comparative Pharmacology
Head-to-head clinical analysis: DIALYTE CONCENTRATE W DEXTROSE 50 IN PLASTIC CONTAINER versus EXTRANEAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DIALYTE CONCENTRATE W DEXTROSE 50 IN PLASTIC CONTAINER versus EXTRANEAL.
DIALYTE CONCENTRATE W/ DEXTROSE 50% IN PLASTIC CONTAINER vs EXTRANEAL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Provides dextrose as a caloric source and electrolyte replacement in peritoneal dialysis. Dextrose is metabolized to carbon dioxide and water, generating ATP. The high osmolality of the solution promotes ultrafiltration of fluid across the peritoneal membrane, facilitating removal of uremic toxins and excess fluid.
Extraneal (icodextrin) is a glucose polymer that acts as an osmotic agent for peritoneal dialysis. It is absorbed from the peritoneal cavity into the bloodstream and metabolized to maltose and other oligosaccharides. Its primary mechanism is to create an osmotic gradient across the peritoneal membrane, facilitating ultrafiltration and removal of waste products.
Not applicable; dialysate concentrate is used in hemodialysis machines, not administered directly to patients. Dextrose concentration in final dialysate is typically 1.5-2.5 g/dL depending on prescription.
7.5% solution: 2 L intraperitoneally, dwell time 4–8 hours, up to 4 exchanges per day. For automated peritoneal dialysis: 2 L per cycle, typically 3–5 cycles overnight.
None Documented
None Documented
Not applicable as a fixed half-life; glucose has a plasma elimination half-life of approximately 15-20 minutes, but this is concentration-dependent. Dialysis solutions are not administered as a single intravenous dose; the components are continuously infused.
The terminal elimination half-life of icodextrin in plasma is approximately 19 hours (range 12-22 hours) following intraperitoneal administration for a dwell of 8-12 hours. This long half-life reflects slow metabolism and clearance, particularly relevant in patients with impaired renal function, leading to accumulation of maltose and other oligosaccharides.
Renal excretion of glucose and electrolytes; glucose is completely reabsorbed or metabolized, while electrolytes are excreted proportionally to serum levels and renal function. 100% renal elimination of administered electrolytes.
Icodextrin is metabolized to maltose, maltotriose, and other oligosaccharides. After intraperitoneal administration, approximately 40% of the administered dose is absorbed systemically; the absorbed icodextrin and its metabolites are primarily eliminated by renal excretion (via glomerular filtration). In patients with residual renal function, approximately 30-40% of the absorbed dose is excreted in urine over 14 days. Biliary/fecal excretion is negligible (<1%).
Category C
Category C
Peritoneal Dialysis Solution
Peritoneal Dialysis Solution