Comparative Pharmacology
Head-to-head clinical analysis: DIANEAL 137 W DEXTROSE 1 5 IN PLASTIC CONTAINER versus EXTRANEAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DIANEAL 137 W DEXTROSE 1 5 IN PLASTIC CONTAINER versus EXTRANEAL.
DIANEAL 137 W/ DEXTROSE 1.5% IN PLASTIC CONTAINER vs EXTRANEAL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
DIANEAL 137 with 1.5% dextrose is a peritoneal dialysis solution that removes waste products and excess fluid from the blood by creating a concentration gradient across the peritoneal membrane via diffusion and ultrafiltration. Dextrose acts as an osmotic agent to drive fluid removal.
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, typically 4 exchanges per day for continuous ambulatory peritoneal dialysis (CAPD).
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 for dextrose as it is an endogenous substance. Exogenous dextrose in peritoneal dialysis is rapidly metabolized; plasma glucose half-life is approximately 1-2 hours after absorption, but this varies with metabolic state.
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.
Dianeal 137 with 1.5% dextrose is a peritoneal dialysis solution. Dextrose is metabolized systemically; glucose is absorbed via peritoneal route and undergoes endogenous metabolism. Icodextrin (if applicable) is metabolized to maltose and excreted renally, but for this standard solution, elimination is primarily via metabolism to CO2 and water; less than 5% excreted unchanged in urine. No biliary or fecal elimination of intact dextrose.
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