A 66-year-old patient is being prepared for surgery to repair an inguinal hernia. The patient has a history of end-stage renal disease and undergoes home peritoneal dialysis with icodextrin (Extraneal). In this patient, which of the following values is most likely to be falsely elevated?
Icodextrin is a relatively common solution used for peritoneal dialysis. It is metabolized to maltose in the body, which can produce falsely high readings on certain point-of-care blood glucometers. These falsely high readings have resulted in patients having unrecognized hypoglycemia, which could result in permanent neurological damage or even death. Icodextrin has a long half-life in the body and can affect blood glucose readings for up to 14 days after discontinuation.
Most point-of-care glucose measurements are accomplished by methods that are susceptible to interference by icodextrin. Glucose dehydrogenase pyrroloquinoline quinone (GDH-PQQ), glucose-dye-oxidoreductase (GDO) and glucose dehydrogenase flavin adenine dinucleotide (GDH-FAD) are all common methods for...
