Falsely Elevated Glucose Concentrations in Peritoneal Dialysis Patients Using Icodextrin.
BACKGROUND
Peritoneal dialysis (PD) is used as an alternative to hemodialysis in end-stage renal disease (ESRD). Icodextrin has been used as a hyperosmotic agent in PD. The aim of the study was to assess two different point-of-care testing (POCT) glucose strips, affected and not affected by icodextrin, with serum glucose concentrations of the patients using and not using icodextrin.


METHODS
Fifty-two chronic ambulatory peritoneal dialysis (CAPD) patients using icodextrin (Extraneal®) and 20 CAPD patients using another hyperosmotic fluid (Dianeal®) were included in the study. Duplicate capillary and serum glucose concentrations were measured with two different POCT glucose strips and central laboratory hexokinase method. Assay principles of glucose strips were based on glucose dehydrogenase-pyrroloquinoline quinone (GDH-PQQ) and a mutant variant of GDH (Mut Q-GDH). The results of both strips were compared with those of hexokinase method.


RESULTS
Regression equations between POCT and hexokinase methods in icodextrin group were y = 2.55x + 1.12 mmol/l and y = 1.057x + 0.16 mmol/l for the GDH-PQQ and Mut Q-GDH methods, respectively. The mean difference between the results of hexokinase and those of GDH-PQQ and Mut Q-GDH in icodextrin group was 3.41 ± 1.56 and 0.72 ± 0.64 mmol/l, respectively. However, the mean differences were found much lower in the control group; 0.64 mmol/l for GDH-PQQ and 0.52 mmol/l for Mut Q-GDH.


CONCLUSIONS
Compared to GDH-PQQ, glucose strips of Mut Q-GDH correlated better with hexokinase method in PD patients using icodextrin.
Department of Clinical Biochemistry, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey.
Kübra
K
Dogan
Department of Clinical Biochemistry, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey.
Damla
D
Kayalp
Department of Clinical Biochemistry, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey.
Gözde
G
Ceylan
Department of Nephrology, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey.
Alper
A
Azak
Department of Clinical Biochemistry, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey.
Mehmet
M
Senes
Department of Nephrology, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey.
Murat
M
Duranay
Department of Clinical Biochemistry, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey. doyucel@yahoo.com.
Dogan
D
Yucel
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects*; D005260:Female; D005936:Glucans / Q000494:pharmacology*; D005947:Glucose / Q000494:pharmacology*; D005948:Glucose Dehydrogenases / Q000378:metabolism; D006403:Hematologic Tests; D015312:Hemodialysis Solutions / Q000494:pharmacology*; D006593:Hexokinase / Q000494:pharmacology; D006801:Humans; D000077607:Icodextrin; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000628:therapy*
D001786:Blood Glucose; D005936:Glucans; D015312:Hemodialysis Solutions; D000077607:Icodextrin; D005948:Glucose Dehydrogenases; C033955:glucose dehydrogenase (pyrroloquinoline-quinone); D006593:Hexokinase; D005947:Glucose
glucose; icodextrin; interference; peritoneal dialysis; point-of-care testing