Comparative Pharmacology
Head-to-head clinical analysis: DIANEAL LOW CALCIUM W DEXTROSE 4 25 IN PLASTIC CONTAINER versus EXTRANEAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DIANEAL LOW CALCIUM W DEXTROSE 4 25 IN PLASTIC CONTAINER versus EXTRANEAL.
DIANEAL LOW CALCIUM W/DEXTROSE 4.25% IN PLASTIC CONTAINER vs EXTRANEAL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Sterile, nonpyrogenic, hyperosmotic solution containing dextrose as osmotic agent; creates osmotic gradient across peritoneal membrane to remove excess fluid and waste products via diffusion and ultrafiltration.
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 daily, with dwell times of 4-6 hours; dextrose concentration adjusted to achieve ultrafiltration goals.
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 intraperitoneal dextrose; systemic glucose half-life ~1.5-3 h in normal metabolic state. Peritoneal dialysis of dextrose reflects continuous absorption 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.
Peritoneal elimination; glucose absorbed systemically is metabolized via glycolysis, with <5% excreted unchanged in urine. Dextrose removal relies on diffusion into dialysate; net ultrafiltrate exits via peritoneal catheter.
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