2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6b6,Icodextrin is an alternative peritoneal dialysis (PD) solution with favorable fluid management and metabolic properties. Given the limited evidence regarding the use of icodextrin in patients with pre-existing congestive heart failure (CHF), this study aimed to examine the association between icodextrin use and clinical outcomes in PD patients. We conducted a retrospective cohort study using the Chang Gung Research Database (CGRD), including 1 800 eligible PD patients with CHF from 2005 to 2022 in Taiwan, followed through June 2023. Icodextrin users (≥50% of PD duration) were compared with non-users. Primary outcomes included all-cause mortality, cardiovascular mortality, sudden death, and major adverse cardiovascular events (MACE). Multivariable Cox proportional hazards models incorporating time-varying exposure to icodextrin were applied. To evaluate the robustness of our primary analysis, we conducted a target trial emulation framework and an alternative time-dependent data structure as sensitivity analyses. Icodextrin use was associated with lower risks of all-cause mortality (adjusted hazard ratio [HR]: 0.16, 95% confidence interval [CI]: 0.13-0.20), cardiovascular mortality (HR: 0.20, 95% CI: 0.13-0.30), sudden death (HR: 0.15, 95% CI: 0.11-0.19), and MACE (HR: 0.68, 95% CI: 0.58-0.80). Icodextrin users also showed associations with reduced risks of encapsulating peritoneal sclerosis and transition to hemodialysis but lower transplantation rates. In PD patients with CHF, icodextrin use was independently associated with better survival and cardiovascular outcomes. These findings support its preferential use in high-risk PD populations and warrant further prospective investigation.31:T92e,ABSTRACT Background Icodextrin is an alternative peritoneal dialysis (PD) solution with favorable fluid management and metabolic properties. Given the limited evidence regarding the use of icodextrin in patients with pre-existing congestive heart failure (CHF), this study aimed to examine the association between icodextrin use and clinical outcomes in PD patients. Methods We conducted a retrospective cohort study using the Chang Gung Research Database (CGRD), including 1800 eligible PD patients with CHF from 2005 to 2022 in Taiwan, followed through June 2023. Icodextrin users (≥50% of PD duration) were compared with non-users. Primary outcomes included all-cause mortality, cardiovascular mortality, sudden death and major adverse cardiovascular events (MACE). Multivariable Cox proportional hazards models incorporating time-varying exposure to icodextrin were applied. To evaluate the robustness of our primary analysis, we conducted a target trial emulation framework and an alternative time-dependent data structure as sensitivity analyses. Results Icodextrin use was associated with lower risks of all-cause mortality [adjusted hazard ratio (HR) 0.16, 95% confidence interval (CI) 0.13–0.20], cardiovascular mortality (HR 0.20, 95% CI 0.13–0.30), sudden death (HR 0.15, 95% CI 0.11–0.19) and MACE (HR 0.68, 95% CI 0.58–0.80). Icodextrin users also showed associations with reduced risks of encapsulating peritoneal sclerosis and transition to hemodialysis but lower transplantation rates. Conclusions In PD patients with CHF, icodextrin use was independently associated with better survival and cardiovascular outcomes. These findings support its preferential use in high-risk PD populations and warrant further prospective investigation. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Congestive Heart Failure: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Congestive Heart Failure (condition). Clinician-written summaries and actionable practice insights. 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The abstract provided in the metadata appears to be from a different paper. Summaries and tags reflect the actual full text content.","value_numeric":null}],"summaries":{"what_studied":"This paper describes and evaluates Polaris, a multi-agent LLM constellation system (~1 trillion total parameters) designed for real-time, voice-based, non-diagnostic patient-AI healthcare conversations — covering medication review, lab/vital interpretation, nutrition guidance, and hospital policy Q&A.","key_result":"In subjective evaluation by >1,100 U.S.-licensed nurses and >130 physicians across 3,475+ conversations, Polaris matched or exceeded human nurses on bedside manner (86.3% vs. 82.7%), patient education (88.2% vs. 78.5%), and medical safety (96.9% 'nothing incorrect' vs. 81.2%). On task-specific benchmarks, Polaris outperformed GPT-4 on key capabilities: lab reference range identification (96% vs. 78%), OTC toxicity detection (82% vs. 38%), condition-specific disallowed OTCs (89% vs. 56%), and hospital policy Q&A (86% vs. 36%).","limitations":"- Evaluators were healthcare professionals acting as patients, not real patients — limiting generalizability to actual patient populations.\n- All use cases focused on three conditions (CHF, CKD, colonoscopy prep); performance in other clinical contexts is unknown.\n- Training data and physician-approved reference tables are proprietary, making independent replication difficult.","practice_takeaway":"A safety-focused, voice-based AI agent can perform on par with human nurses for non-diagnostic patient calls, including medication review, lab interpretation, and dietary guidance — with built-in escalation to human clinicians for high-risk situations. Clinicians considering AI-assisted patient outreach should note this system is designed to augment, not replace, licensed staff, and has not yet been validated in real (non-simulated) patient populations."}},{"doi":"10.1093/ndt/gfaf265","pmid":"41388906","title":"The effect of icodextrin on peritoneal dialysis patients with congestive heart failure: a time-varying exposure design and target trial emulation approach","journal_title":"Nephrology Dialysis Transplantation","journal_issn":"0931-0509","published_at":"2025-12-13T00:00:00.000Z","url":"https://doi.org/10.1093/ndt/gfaf265","source_score":25,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-16","doi":"10.1093/ndt/gfaf265","days":"30","issn":"0931-0509","rank":"10","field":"Clinical Medicine","score":"25","category":"Urology & Nephrology","categories":["Urology & Nephrology"],"_categories":["Urology & Nephrology"]},"pubmed":{"doi":"10.1093/ndt/gfaf265","title":"The effect of icodextrin on peritoneal dialysis patients with congestive heart failure: a time-varying exposure design and target trial emulation approach.","journal":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","methods":"","results":"Icodextrin use was associated with lower risks of all-cause mortality (adjusted hazard ratio [HR]: 0.16, 95% confidence interval [CI]: 0.13-0.20), cardiovascular mortality (HR: 0.20, 95% CI: 0.13-0.30), sudden death (HR: 0.15, 95% CI: 0.11-0.19), and MACE (HR: 0.68, 95% CI: 0.58-0.80). 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Icodextrin users (≥50% of PD duration) were compared with non-users for all-cause and cardiovascular mortality, sudden death, and MACE using Cox models with time-varying exposure; target trial emulation and an alternative time-dependent structure were used as sensitivity analyses.","key_result":"Icodextrin use was associated with lower risks of all-cause mortality (adjusted HR 0.16, 95% CI 0.13–0.20), cardiovascular mortality (HR 0.20, 95% CI 0.13–0.30), sudden death (HR 0.15, 95% CI 0.11–0.19), and MACE (HR 0.68, 95% CI 0.58–0.80). Users also had lower risks of encapsulating peritoneal sclerosis and transition to hemodialysis, but lower transplantation rates (no numbers reported).","practice_takeaway":"For PD patients with CHF, icodextrin use was linked to markedly lower mortality and cardiovascular events in this large cohort. These data support considering icodextrin preferentially in high-risk PD patients, while awaiting prospective confirmation."}}],"initialOffset":2,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Congestive Heart Failure"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Congestive Heart Failure"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Congestive Heart Failure"}}}]]

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