Analysis of Erroneous Overestimation of Blood Glucose in Patients on Continuous Ambulatory Peritoneal Dialysis with Icodextrin.
- Author:
Mina YU
1
;
Eun Wha CHOI
;
Hae jung JANG
;
Min Jung KANG
;
Dong Ryeol RYU
;
Seung Jung KIM
;
Duk Hee KANG
;
Kyun Il YOON
;
Kyu Bok CHOI
Author Information
1. Division of Nephrology, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea. kbchoi@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Icodextrin;
Hypoglycemia
- MeSH:
Blood Glucose*;
Capillaries;
Glucan 1,4-alpha-Glucosidase;
Glucose;
Glucose Oxidase;
Humans;
Hypoglycemia;
Maltose;
Oxidoreductases;
Peritoneal Cavity;
Peritoneal Dialysis, Continuous Ambulatory*
- From:Korean Journal of Nephrology
2007;26(1):79-86
- CountryRepublic of Korea
- Language:Korean
-
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.
