How do you determine the fill volume of icodextrin for a volume-overloaded ESKD on PD patient considering that the dwell may last throughout the day?

For patients with acute, symptomatic volume overload, hypertonic dextrose solutions are often used as these solutions act more quickly. Icodextrin is typically not used in an acute setting because it acts more slowly. However, for patients who are asymptomatic, icodextrin can be used in the long dwell to increase fluid removal particularly in patients with a high transport peritoneal membrane characteristic. Typically, a fill volume of icodextrin is initially prescribed at 1L to 1.5L as this smaller fill volume takes into consideration the increase in intra-abdominal pressure in the sitting position. The fill volume can be increased incrementally as tolerated to meet both the volume needs and/or solute clearance needs of the patient up to a...