April 2005: Safety Alert
Peritoneal Dialysis Solutions with Icodextrin (Extraneal™) Can Lead to False Elevations in Blood Glucose Monitor ReadingsISMP Canada has received two reports from hospitals, one involving multiple patients, about falsely elevated blood glucose monitor readings for patients receiving a peritoneal dialysis (PD) solution containing icodextrin. In the first report, the patient’s blood glucose level, measured with an Accu-Chek® monitor, was 14.3 mmol/L whereas the serum laboratory value was 3 mmol/L. The patient exhibited decreased level of consciousness and periods of apnea and required treatment with 50% dextrose administered intravenously (IV).
In the second hospital, the blood glucose levels of several patients undergoing peritoneal dialysis were routinely checked with an Accu-Chek® monitor, the glucose readings were 4 to 10 mmol/L higher than the results obtained by laboratory testing of venous samples. In all cases, the patients experienced delays in receiving treatment (dextrose 50% IV or oral glucose) for their hypoglycemia.
This phenomenon has been reported previously. Certain glucose monitoring systems cannot distinguish between icodextrin byproducts (e.g. maltose) and glucose, which leads to falsely elevated glucose readings. Health Canada recently released a Notice to Hospitals as well as an advisory bulletin to diabetic patients using the PD solution containing icodextrin (Extraneal™; sold in Canada by Baxter).
References available upon request.
