Unawareness of Hypoglycemic Convulsion Due to Overestimation of Capillary Blood Glucose Levels in a Peritoneal Dialysis Patient Using Icodextrin / 대한신장학회잡지

ABSTRACT

In patients on peritoneal dialysis, ultrafiltration can be decreased after long-term dialysis. To solve this problem, icodextrin has been developed and used instead of glucose. Icodextrin infused into the peritoneal cavity is partially absorbed via lymphatics into the systemic circulation and hydrolyzed, and then its metabolites lead to measurement of high capillary blood glucose levels by reacting with the test strip. This excessive measurement of capillary blood glucose levels can lead to unawareness of hypoglycemia, but there has been no report of such cases in our country. A 26-year-old female patient who was on peritoneal dialysis with 7.5% icodextrin (Extraneal Baxter Corporation, Chicago, IL, USA) presented with convulsion and hypoglycemia. To alert our physicians, we report it with a review of the literature, and recommend when a patient on peritoneal dialysis with icodextrin, blood sugar levels should be cross checked by other laboratory reference methods.