Abstract: FR-PO471
Quantifying the Waste Associated with Icodextrin in Patients Undergoing Continuous Cycling Peritoneal Dialysis
Session Information
- Home Dialysis - 1
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Ghimire, Anukul, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Ward, David, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Qirjazi, Elena, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Shah, Nikhil A., University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
- Vitale, George, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
Background
Effective healthcare waste (HCW) management and HCW reduction are important considerations for medical programs. Dialysis is associated with significant hazardous and non hazardous HCW. Icodextrin is commonly used in patients undergoing continuous cycling peritoneal dialysis (CCPD). In Canada, Icodextrin for CCPD is only available as 2.5 L, single-use bags. Patient’s often have Icodextrin fill volumes < 2L, with the remainder of the volume being discarded as non-hazardous HCW. We sought to quantify the volume of discarded Icodextrin solution in the CCPD population of the Alberta Kidney Care South (AKC-S) program.
Methods
A cross sectional audit was performed of the AKC-S program including all patients utilizing CCPD in 2022. Data included Icodextrin dwell volume, patient demographics, and estimated costs associated with Icodextrin use in 2021. Descriptive statistics were used to report the data.
Results
Among 205 patients in the AKC-S program on CCPD, the mean age and PD vintage (± standard error of mean) was 62.7 ± 0.9 years and 27.5 ± 2.1 months respectively. The average Icodextrin dwell volume was 1200 mL. 87% of the patients using Icodextrin were using dwell volumes up to 1500 mL. Our patient population tended to be similar in weight compared to those in previous studies evaluating Icodextrin for the long dwell. In 2021, Icodextrin for CCPD cost AKC-S $1.27 million (CAD).
Conclusion
Among patients in the AKC-S program, there is a notable difference in the average fill volume (1200 mL) and available bags of Icodextrin (2.5L) available. This suggests that a large portion of purchased Icodextrin is being discarded as non-hazardous HCW. This practice pattern may also be reflected in other home dialysis programs and further work is needed to (1) understand the large-scale costs and environmental impact associated with Icodextrin waste, (2) develop effective methods to manage HCW in dialysis programs, and (3) implement quality improvement initiatives to reduce HCW associated with peritoneal dialysis.