Comparative Pharmacology
Head-to-head clinical analysis: DIALYTE W DEXTROSE 1 5 IN PLASTIC CONTAINER versus EXTRANEAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DIALYTE W DEXTROSE 1 5 IN PLASTIC CONTAINER versus EXTRANEAL.
DIALYTE W/ DEXTROSE 1.5% IN PLASTIC CONTAINER vs EXTRANEAL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Removes uremic toxins, corrects electrolyte imbalances, and removes excess fluid via peritoneal dialysis.
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.
Intraperitoneal administration: 2 liters per exchange, 4 exchanges per day (typical for continuous ambulatory peritoneal dialysis).
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
Dextrose: ~2-2.5 hours (glucose turnover); electrolytes and lactate have rapid distribution and elimination half-lives of minutes to hours. In renal impairment, half-life of dialyzed solutes may be prolonged.
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.
Primarily renal; glucose and electrolytes are reabsorbed or excreted by kidneys. For IP administration, dialysis fluid components (e.g., dextrose, sodium, chloride, lactate) are absorbed and then eliminated via renal and metabolic pathways: ~60% of absorbed dextrose is metabolized, remainder excreted renally; electrolytes are excreted renally; lactate is metabolized to bicarbonate.
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