Comparative Pharmacology
Head-to-head clinical analysis: DIANEAL LOW CALCIUM W DEXTROSE 1 5 IN PLASTIC CONTAINER versus EXTRANEAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DIANEAL LOW CALCIUM W DEXTROSE 1 5 IN PLASTIC CONTAINER versus EXTRANEAL.
DIANEAL LOW CALCIUM W/DEXTROSE 1.5% IN PLASTIC CONTAINER vs EXTRANEAL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Dianeal Low Calcium with Dextrose 1.5% is a peritoneal dialysis solution that provides osmotic gradient for ultrafiltration and diffusion of solutes across the peritoneal membrane. Dextrose (1.5%) acts as the osmotic agent, creating a concentration gradient that drives water removal. The low calcium concentration (2.5 mEq/L) helps manage hypercalcemia in patients requiring calcium-based phosphate binders.
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 L per exchange, 4 exchanges per day (2.5 L per exchange for larger patients if tolerated).
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
For intraperitoneal dextrose: not clinically applicable as elimination is via continuous peritoneal dialysis. Systemically absorbed dextrose has a half-life of 15-20 minutes due to rapid cellular uptake and metabolism.
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 removed via peritoneal dialysis itself; ~70% of absorbed glucose undergoes metabolism, with remaining glucose and lactate absorbed systemically and metabolized hepatically. Renal elimination of dextrose and lactate is negligible (<5%) due to low systemic absorption and endogenous metabolism.
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