Analytical interferences in point-of-care testing glucometers by icodextrin and its metabolites: an overview

Perit Dial Int. 2009 Jul-Aug;29(4):377-83.

Abstract

Current point-of-care testing (POCT) glucometers are based on various test principles. Two major method groups dominate the market: glucose oxidase-based systems and glucose dehydrogenase-based systems using pyrroloquinoline quinone (GDH-PQQ) as a cofactor. The GDH-PQQ-based glucometers are replacing the older glucose oxidase-based systems because of their lower sensitivity for oxygen. On the other hand, the GDH-PQQ test method results in falsely elevated blood glucose levels in peritoneal dialysis patients receiving solutions containing icodextrin (e.g., Extraneal; Baxter, Brussels, Belgium). Icodextrin is metabolized in the systemic circulation into different glucose polymers, but mainly maltose, which interferes with the GDH-PQQ-based method. Clinicians should be aware of this analytical interference. The POCT glucometers based on the GDH-PQQ method should preferably not be used in this high-risk population and POCT glucose results inconsistent with clinical suspicion of hypoglycemic coma should be retested with another testing system.

Publication types

  • Review

MeSH terms

  • Animals
  • Autoanalysis / instrumentation
  • Blood Glucose / analysis*
  • Dialysis Solutions / chemistry
  • Dialysis Solutions / pharmacokinetics*
  • Glucans / chemistry
  • Glucans / pharmacokinetics*
  • Glucose / chemistry
  • Glucose / pharmacokinetics*
  • Humans
  • Icodextrin
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / therapy*
  • Point-of-Care Systems*
  • Reference Standards

Substances

  • Blood Glucose
  • Dialysis Solutions
  • Glucans
  • Icodextrin
  • Glucose