Korean J Nephrol.  2007 Jan;26(1):79-86.

Analysis of Erroneous Overestimation of Blood Glucose in Patients on Continuous Ambulatory Peritoneal Dialysis with Icodextrin

Affiliations
  • 1Division of Nephrology, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea. kbchoi@ewha.ac.kr

Abstract

PURPOSE: Icodextrin in peritoneal cavity is absorbed via the lymphatics to the blood and metabolized to maltose and maltriose which may interfere with correct measurement of glucose. In an attempt to evaluate the effects of icodextrin on the erroneous results of blood glucose, we measured blood glucose by different methods.
METHODS
Peripheral capillary blood and venous blood were obtained from 12 patients using icodextrin and from 12 patients not using icodextrin. Venous blood glucose was measured by using the laboratory technique (glucose oxidase method), and capillary blood glucose was measured by using a Surestep (glucose oxidase method) and an Acucheck (GDH-PQQ method). To estimate icodextrin and its metabolites indirectly, we calculated osmolal gap. We measured blood icodextrin and its metabolites with amyloglucosidase in icodextrin group.
RESULTS
In icodextrin group, glucose was overestimated in the results of the GDH-PQQ method (delta= GDH-GOD=56.2+/-30 mg/dL [vein] 58+/-32 mg/dL [capillary]), but in the control group, there were no significant differences in the results between the glucose oxidase method and the GDH-PQQ method. There was a correlation between the osmolal gap and the differences in the results (delta=GDH-GOD) (r=0.741, p=.006 [vein], r=0.671, p=.017 [capillary]). Blood icodextrin and its metabolites were related with the differences in the results (delta=GDH-GOD) (p=.026, r=0.635), but there was no significant correlation between the osmolal gap and the icodextrin and its metabolites (p=0.086, r=0.515).
CONCLUSION
Icodextrin and its metabolites may lead to erroneously high blood glucose levels when measured by GDH-PQQ method. It is necessary to be aware of this factor in order to prevent overlooking dangerous hypoglycemia.

Keyword

Icodextrin; Hypoglycemia

MeSH Terms

Blood Glucose*
Capillaries
Glucan 1,4-alpha-Glucosidase
Glucose
Glucose Oxidase
Humans
Hypoglycemia
Maltose
Oxidoreductases
Peritoneal Cavity
Peritoneal Dialysis, Continuous Ambulatory*
Blood Glucose
Glucan 1,4-alpha-Glucosidase
Glucose
Glucose Oxidase
Maltose
Oxidoreductases
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