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- Title
LEUKOPENIJA I TROMBOCITOPENIJA KAO POSLJEDICA PRIMJENE ICODEXTRINA U BOLESNIKA KOJI SE LIJEČI POSTUPCIMA PERITONEJSKE DIJALIZE.
- Authors
MIKOLAŠEVIĆ, IVANA; ORLIĆ, LIDIJA; COLIĆ, MARINA; DEVČIĆ, BOSILJKA; VUJIČIĆ, BOŽIDAR; ANIĆ, KATA; BABIĆ, VESNA; RUNDIÓ, ANA MARIJA; PERŠIĆ, MARTINA PAVLETIĆ; RAČKI, SANJIN
- Abstract
INTRODUCTION: Since the widespread introduction of peritoneal dialysis (PD) into the standard care of patients with chronic kidney disease there has been a shift from the initial focus on technique survival to refinement of the therapy to enhance biocompatibility and improve both the local peritoneal and systemic consequences of PD. One of the most significant contributions to these advances has been the development of novel PD solutions. The use of new manufacturing techniques, buffer presentation, and new osmotic alternatives to glucose have allowed potentially improved peritoneal survival (in terms of structure and function) and improved subjective patient experience. Glucose polymers (eg, icodextrin) are mixtures of oligo/polysaccharides of variable chain lengths. Glucose polymers were introduced in PD treatment to replace glucose-containing solutions by offering the possible advantages of decreased absorption of solute and increased ultrafiltration for a longer period of time. The use of a icodextrin is particularly appealing as a substitute for glucose solutions, particularly in diabetics, in those who require long dwell, and in patients whose ultrafiltration capacity may need to be enhance. Although it has numerous good" effects, it is importan to know its adverse events. Hereby, we report a case of PD patients who develop leukopenia and thrombocytopenia as a consequence of icodextrin use. CASE REPORT: In September 2012. a 67-years-old man referred to our Centre because of End-stage renal disease. We have been started the treatment with a continuous ambulatory peritoneal dialysis (CAPD) and than with an automated peritoneal dialysis (APD). The primary renal disease in our patient was diabetic nephropaty. Because our patient was diabetic and he require a high ultrafiltartion rate due to sign of overhidration, we had dialyzed him with a 7.5% icodextrin solution (Extraneal®, Baxter). Immediately after the applaied protocol he had developed leukopenia (from 2.5 to 3.9x109' and thrombocytopenia (from 100 to 137 X 109). During the subsequent period due to repeated fluid overload and overall negative daily ultrafiltration, and a strong effort intolerance we had started a hemodialysis procedure sin our patient. Few days after discontinuing treatment with APD and icodextrin the values of leukocytes (4.5 x 109) and thrombocytes (168 X 109/L) were recovered. Also, he had no signs of fluid overload any more. CONCLUSION: In everyday clinical practice, it is essential to understanding the adverse events of the applied therapy. In this way, we can on time stop using the composition, and we can spare" our patients from unnecessary diagnostic procedures.
- Publication
Acta Medica Croatica, 2014, Vol 68, p164
- ISSN
1330-0164
- Publication type
Article