Hong Kong Journal of Nephrology

Volume 6 Number 2, 2004
Abstract

Blood Glucose Overestimation Using Hemoglucostix in a Diabetic Patient on Icodextrin-based Peritoneal Dialysis

Wai-Leung Chak
chakwaileung@hotmail.com

Francis Kim-Ming Wong

Ying-Wai Ng, Endocrine Unit, Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China.

Ho-Sing Wong
Koon-Shing Choi
Ka-Foon Chau

Sau-Cheung Tiu, Endocrine Unit, Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China.

Chun-Sang Li

Renal Unit, Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China.

Icodextrin is a newly available glucose-free peritoneal dialysis solution that can be used in diabetic patients with poor glycemic control. It is less readily absorbed from the peritoneal cavity and, hence, has the advantage of reduced glucose absorption. This new osmotic agent, however, is not metabolically inert. Absorption of icodextrin can result in accumulation of oligosaccharide metabolites that interfere with some laboratory tests. We report a patient suffering from spurious hyperglycemia after using this new osmotic agent. Various mechanisms of hemoglucostix are discussed to provide information to clinicians on one important potential complication of this new osmotic agent.

Key words: hyperglycemia, icodextrin, peritoneal dialysis

Icodextrin 是新面世不含葡萄糖的腹膜透析液,適用於血糖控制欠佳的糖尿病患者,其吸收速度並不迅速,有助維持血糖值的穩定。Icodextrin 有利於滲透壓的維持,但並非不受代謝的影響。Icodextrin 的吸收可導致寡糖代謝物的積聚,並對某些實驗室化驗結果造成影響。在以下的一例個案中,病人在使用 icodextrin 後,血糖測試呈現血糖過高的偽結果。本文同時簡述了 hemoglucostix 測試法的原理,就 icodextrin 對此化驗法的影響作出初步探討。


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