Can icodextrin interfere with results of point of care glucometer results?
“Point of Care” (POC) glucometers and test strips that do not use glucose-specific methodologies cannot discern the difference between glucose and other sugars in the blood (e.g., maltose). While icodextrin is not absorbed across the peritoneal membrane, some is absorbed via peritoneal lymphatics and eventually reaches the systemic circulation. There it undergoes metabolism by amylase, with the main metabolite being maltose. Given limited kidney excretion in patients with ESKD, plasma levels of icodextrin and maltose metabolites with once daily use reach stable levels that do not return to baseline values for at least 2 weeks following complete cessation of icodextrin use. As such, nonglucose-specific POC glucometers may result in falsely elevated blood glucose readings in patients on icodextrin. This could either result in the masking of true hypoglycemia or provide falsely elevated blood glucose reading, situations that could lead to erroneous clinician action and potentially life-threatening events. Patients on icodextrin should therefore have blood glucose measurements done exclusively with glucose-specific POC monitors or, if hospitalized, have their blood glucose values ascertained by the clinical chemistry laboratory.