Author/Editor		Ekart, Robert; Pečovnik-Balon, Breda; Dvoršak, Benjamin; Hojs, Radovan
Title		Sterilni peritonitis nakon primjene ikodekstrina
Translated title		Sterile peritonitis after application of icodextrin
Type		članek
Source		Acta Med Croatica
Vol. and No.		Letnik 56, št. 4-5
Publication year		2002
Volume		str. 185-7
Language		cro
Abstract		Introduction. Icodextrin is an 7.5% isoosmotic solution of the glucose polymer maltodextrin, recently frequently used in continuous ambulatory peritoneal dialysis (CAPD). It improves ultrafiltration and decreases glucose absorption. Among side effects of icodextrin, skin reactions and sterile peritonitis have been described. The authors present two cases of sterile peritonitis after icodextrin. Clinical presentation. In these two patients, the adverse events included peritoneal reaction to icodextrin solution. The reaction did not occur immediately after the initial administration of icodextrin, but after 70 (case 1) and 412 days (case 2) of regular use. This reaction to icodextrin solution resembled chemical peritonitis, however, the clinical picture was not absolutely typical of bacterial peritonitis either. Both patients had cloudy dialysate, elevated WBC in dialysate, no microorganisms were isolated, and no signs of allergic reaction could be detected. The clinical course was characterized by rapid remission upon isodextrin withdrawal. One patient received empiric antibiotic therapy, the other did not. Upon switching from icodextrin to glucose-based dialysate, the two patients were not challenged to icodextrin, and were doing well, without any symptoms of peritonitis. Discussion and conclusion. The icodextrin solution contains an isoosmolar glucose polymer which allows longterm stable ultrafiltration. Among side effects, cutaneous reactions have been described (exfoliative, in the form of vesicles, psoriatic plaque or generalized exanthema in the form of pustules), which may occur in as many as 15% of patients. These symptoms and signs disappear upon discontinuation of icodextrin. Icodextrin side effects also include mild abdominal pain, allergic and hypersensitivity reactions, and recently sterile peritonitis. The patients described developed a clinical picture suggestive of chemical peritonitis. (Abstract truncate at 2000 characters).
Descriptors		PERITONITIS PERITONEAL DIALYSIS, CONTINUOUS AMBULATORY DIALYSIS SOLUTIONS GLUCANS GLUCOSE ADULT MIDDLE AGE