Blood glucose overestimation in diabetic patients on continuous ambulatory peritoneal dialysis for end-stage renal disease.
OBJECTIVE
Diabetic patients on continuous ambulatory peritoneal dialysis (CAPD) for renal failure depend on glucose analysers for regular monitoring of glycaemic control. We aim to inform health professionals of the potentially dangerous overestimation of blood glucose values by some analysers in patients using Icodextrin for dialysis.


METHODS
Twenty-five patients on continuous ambulatory peritoneal dialysis (10 patients on an 8-12-h nocturnal exchange of Icodextrin) had random glucose analysis performed on venous blood using standardized reference laboratory (lab) technique (glucose oxidase GOD-PAP), and simultaneously on capillary blood using the Precision Q.I.D System (glucose oxidase method) and the Advantage meter (glucose dehydrogenase method).


RESULTS
The Precision Q.I.D System agreed with the lab results in both the Icodextrin group and the non-Icodextrin group (80-90% of values fell within 20% of the corresponding lab result). In contrast, the Advantage meter agreed with the lab results only in the non-Icodextrin group (95% of values within 20% of the corresponding lab value), and not in the Icodextrin group, where only 5% of the analyser values fell within 20% of the corresponding lab value.


CONCLUSIONS
The Precision Q.I.D System, which utilizes glucose oxidase reaction, is safe for use in diabetic patients treated with Icodextrin. All analysers must be cross-checked with the laboratory reference method before use in these patients.
Oyibo
Samson O
SO
Department of Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. samson@dc.cmht.nwest.nhs.uk
Pritchard
G M
GM
McLay
L
L
James
E
E
Laing
I
I
Gokal
R
R
Boulton
A J M
AJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003928:Diabetic Nephropathies / Q000097:blood* / Q000628:therapy; D003951:Diagnostic Errors; D015314:Dialysis Solutions / Q000008:administration & dosage / Q000378:metabolism; D005260:Female; D005936:Glucans / Q000008:administration & dosage / Q000378:metabolism; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D000077607:Icodextrin; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods; D012680:Sensitivity and Specificity
D001786:Blood Glucose; D015314:Dialysis Solutions; D005936:Glucans; D005947:Glucose; D006442:Glycated Hemoglobin; D000077607:Icodextrin