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Objective: The purpose of this study is to investigate the benefits of using a nightly icodextrin peritoneal dialysis (PD) solution in a cardiorenal (diuretic-resistant congestive heart failure) patient. Icodextrin is a glucose polymer that has been used as a replacement for the glucose traditionally used in the PD long dwells, as the oncotic pressure gradient can be maintained at adequate ultrafiltration (UF) values for 8-12 hours during sleep. Icodextrin-based solutions (ICO) are well tolerated, lack the metabolic side effects of glucose, and enhance the clearance of small and middle-sized molecules as a consequence of increased convective flow. Patients using one exchange nightly lead a more “normal” life when compared to patients using continuous cycling peritoneal dialysis (CCPD) with glucose solutions, as CCPD requires a nightly cycler apparatus which restricts the patient ability to ambulate at night. Design: This study provides data from a sample size of 16 individuals (12 males and 4 females), 12 of whom are using once-nightly icodextrin peritoneal dialysis, three patients are using continuous cycling peritoneal dialysis, and one patient who is a combination of both a hybrid. Hospital admissions over an equal date range before and after starting extraneal dialysis treatment were compared. Additionally, a ‘Quality of Life’ questionnaire was made using ‘Kidney Disease Quality of Life SF-36’, and other factors affecting that could affect a patient’s quality of life. Results: In our study, we observed that patients using once-nightly icodextrin exchange had fewer hospitalizations (p=0.0149) and reported an overall better quality of life(p=0.009) after initiation of icodextrin peritoneal dialysis with decreased hospital admissions for CHF and progressive chronic kidney disease. Conclusions: By augmenting UF in the cardiorenal patient with recurrent episodes of decompensated heart failure through once-nightly icodextrin exchanges, patients receive adequate clearance with preserved residual renal function as well as fewer hospitalizations. In addition, patients report more restful sleep and a better quality of life as a result of not being attached to a machine at night. They also enjoy being able to travel with their solutions delivered to their destination without having to carry a cycler. *Correspondence to: Ravleen Kaur Saini and Jaibir Singh Bhullar, Department of Medicine, Avalon University School of Medicine, Ohio, Tel: 3307598008; E-mail: ravleensaini@gmail.com; jbhullar25@gmail.com

Lower risk of hospitalizations and higher quality of life in cardiorenal patients using once-nightly Icodextrin peritoneal exchanges