Analytical interferences in point-of-care testing glucometers by icodextrin and its metabolites: an overview.
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.
Floré
Katelijne M J
KM
Department of Clinical Chemistry, University Hospital Ghent, Belgium.
Delanghe
Joris R
JR
D000818:Animals; D001322:Autoanalysis / Q000295:instrumentation; D001786:Blood Glucose / Q000032:analysis*; D015314:Dialysis Solutions / Q000737:chemistry / Q000493:pharmacokinetics*; D005936:Glucans / Q000737:chemistry / Q000493:pharmacokinetics*; D005947:Glucose / Q000737:chemistry / Q000493:pharmacokinetics*; D006801:Humans; D000077607:Icodextrin; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D019095:Point-of-Care Systems; D012015:Reference Standards
D001786:Blood Glucose; D015314:Dialysis Solutions; D005936:Glucans; D000077607:Icodextrin; D005947:Glucose