The Korean Journal of Internal Medicine

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Original Article
Korean J Med. 2008;74(2):170-175.
원저 : Icodextrin 복막투석 환자에서 혈당 측정
윤세희 . 최낙원 . 윤성로, ,
Blood glucose analysis in patients on continuous ambulatory peritoneal dialysis with Icodextrin
Se Hee Yoon, Nak Won Choi, Sung Ro Yun
한림대학교 의과대학 춘천성심병원 내과, 산부인과1


Abstract
Background/Aims : Icodextrin (glucose polymer) is metabolized by a-amylase to oligosaccharides such as maltose and maltotriose. The presence of these metabolites could have an effect on the enzymatic glucose measurement especially the glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ) based method. Patients treated with icodextrin are at risk for inaccurate blood glucose measurements. In this study we measured the blood glucose with different methods and analyzed the results to determine the test accuracy. Methods : The blood glucose was measured, in seven outpatients and in seven inpatients using icodextrin, by the glucose hexokinase laboratory technique method as well as the GDH-PQQ method (Accu Chek Active)at the same time. To estimate an icodextrin residual effect, after discontinuing icodextin, the blood glucose was measured by the two methods after 48 hours in 4 inpatients. Results : In seven outpatients the blood glucose was overestimated by the Accu Chek Active method (mean difference 68 mg/dL, p value 0.012). In seven inpatients the mean difference in the glucose was 56 mg/dL at 6am, 52 mg/dL at 11am, 52 mg/dL at 4pm, and 50 mg/dL at 9pm by the two different methods. In the four inpatients after changing their dialysate, the mean difference in the glucose was 58 mg/dL after 10 hours, 45 mg/dL after 24 hours, 24 mg/dL after 34 hours, and 26 mg/dL after 48 hours. Conclusion : Blood glucose was overestimated by the GDH-PQQ method and the inaccuracies were observed for more than 48 hours.

Keywords :Icodextrin, Hypoglycemia
hanmi ckdpharm. AMGEN
Memo patch yungjin daewoongbio

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