Comparative Pharmacology
Head-to-head clinical analysis: DIANEAL PD 2 W DEXTROSE 4 25 IN PLASTIC CONTAINER versus EXTRANEAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DIANEAL PD 2 W DEXTROSE 4 25 IN PLASTIC CONTAINER versus EXTRANEAL.
DIANEAL PD-2 W/ DEXTROSE 4.25% IN PLASTIC CONTAINER vs EXTRANEAL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
DIANEAL PD-2 with 4.25% dextrose is a peritoneal dialysis solution that creates an osmotic gradient across the peritoneal membrane, promoting diffusion and convection of solutes and ultrafiltration of fluid from the blood into the peritoneal cavity. Dextrose is absorbed systemically and metabolized, providing caloric load.
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 to 2.5 L per exchange, 4 exchanges per day (continuous ambulatory peritoneal dialysis) or as prescribed for automated peritoneal dialysis. Dextrose 4.25% used for ultrafiltration. Dose adjusted based on patient's peritoneal membrane transport characteristics and fluid status.
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 glucose is continuously absorbed; systemic half-life of absorbed dextrose ~1-2 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, peritoneal; ~80% removed via peritoneal dialysis, remainder metabolized to CO2 and water
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