Comparative Pharmacology
Head-to-head clinical analysis: DIANEAL LOW CALCIUM W DEXTROSE 2 5 IN PLASTIC CONTAINER versus EXTRANEAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DIANEAL LOW CALCIUM W DEXTROSE 2 5 IN PLASTIC CONTAINER versus EXTRANEAL.
DIANEAL LOW CALCIUM W/DEXTROSE 2.5% IN PLASTIC CONTAINER vs EXTRANEAL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
The dextrose component provides osmotic pressure for peritoneal dialysis, promoting ultrafiltration of fluid and removal of solutes. Calcium and other electrolytes maintain physiologic balance.
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: Continuous ambulatory peritoneal dialysis (CAPD): 2-2.5 L per exchange, 4-5 exchanges per day; Continuous cyclic peritoneal dialysis (CCPD): 2-2.5 L per exchange, 3-5 nocturnal exchanges plus one daytime dwell.
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 solution; glucose half-life ~20-30 min in circulation; clinical effect duration corresponds to dwell time (4-6 hours for standard exchange)
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 eliminated via peritoneal dialysis; glucose is metabolized systemically and excreted as CO2 and water; <5% renal excretion of metabolites
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