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The following is a summary of “Bimodal solutions in peritoneal dialysis: what can we expect from different glucose volumes added to the icodextrin bag? Data from a simulation procedure,” published in the April 2025 issue of Journal of Nephrology by Davy et al. 

Researchers conducted a retrospective study to address ultrafiltration (UF) insufficiency in peritoneal dialysis (PD) using bimodal solutions that combined crystalloid and colloid to enhance fluid removal. 

They prepared 3 bimodal PD solutions with 100 ml (solution 100), 150 ml (solution 150) and 200 ml (solution 200) of 30% glucose for intravenous (IV) infusion. Biochemical analyses and computer simulations based on the 3-pore model assessed Na and UF efficiency. Data on the clinical use of solution 200 were retrospectively collected. 

The results showed that adding 30% glucose to icodextrin 7.5% created a low-sodium solution. After a 6-h dwell with solution 200 in a high-average transporter (D/P creatinine 0.7), UF was 943.0 ml and sodium removal were 8.29 g, compared to 650.3 ml and 6.14 g with solution 100. Solution 100 had the best UF, and sodium efficiency based on glucose absorbed. Of these 4 patients used solution 200 for at least 2 months between 2018 and 2023. Mean PD time before bimodal PD was 26 months (6–38), and median time on bimodal PD was 15 months (12–19). No peritonitis was reported. 

Investigators described a simple method to prepare a bimodal solution. They found that adding 100 ml of 30% glucose to 2 L of icodextrin 7.5% gave the best UF and sodium efficiency. 

Source: link.springer.com/article/10.1007/s40620-025-02206-8