Comparative Pharmacology
Head-to-head clinical analysis: DIANEAL PD 1 W DEXTROSE 2 5 IN PLASTIC CONTAINER versus EXTRANEAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DIANEAL PD 1 W DEXTROSE 2 5 IN PLASTIC CONTAINER versus EXTRANEAL.
DIANEAL PD-1 W/ DEXTROSE 2.5% IN PLASTIC CONTAINER vs EXTRANEAL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Dextrose is a monosaccharide that serves as a caloric agent and increases osmotic pressure to facilitate ultrafiltration during peritoneal dialysis. The osmotic gradient created by dextrose drives the removal of waste products and excess fluid from the blood across the peritoneal membrane.
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 (or appropriate volume based on body size) infused over 10-20 minutes, dwell time 4-6 hours, then drain; typically 4 exchanges per 24 hours.
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; dextrose is rapidly metabolized with a half-life of minutes; peritoneal dialysis dwell time is typically 4-6 hours.
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.
Renal: 100% (dextrose is fully metabolized; water and electrolytes are removed via peritoneal dialysis, not excreted unchanged).
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