Yes, Icodextrin is metabolised to maltose, maltotriose and
maltotetraose, although not all CAPD patients are affected. Roche
are adding a statement to their pack inserts about Icodextrin and
use of plasma expanders.
Refs:
Clin Chem 44(11) (1998) p 2379 (letter) Janssen et al
1: Perit Dial Int 18(6) p603 "Previously undescribed side effect of
icodextrin: overestimate of glycaemia by glucose analyser" Wens
et al
No reference to how maltose is removed from blood. Try
contacting David Owolabi at Roche. The number I have is 01273
484573.
> We recently had a case of significant discrepancies between a glucose
> meter and the lab method. The meter was a Roche Accutrend Inform
> (glucose dehydrogenase) and the lab method is glucose oxidase.
>
> The discrepancy occurred shortly after tha patient had been given IV
> human immunoglobulin - "Octagam". Octagam contains 40% maltose, and the
> native preparation gives a very high reading with the glucose meter but
> not with the glucose oxidase method. How is maltose removed from blood
> when given IV?
>
> I wanted to confirm this finding before reporting to the MDA by looking
> at a few more patients, but such is the rampant beaurocracy of the NHS
> that I am required to submit a full research proposal to be allowed to
> take three blood samples.
>
> I thought it would be easier to try the mailbase instead on the
> understanding that, in publishing circles, if three other people think
> so it becomes a well known fact.
>
> Incidentally, I recently heard from Roche that the basis of Icodextrin
> interference is that it is metabolised to maltose, maltotriose and
> maltotetraose.
>
> Doug Hirst
> Biochemistry Dept
> Bradford Royal Infirmary
>
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________________________________________________
Dr MJ Pearson
Department of Clinical Biochemistry & Immunology
Old Medical School
Leeds General Infirmary (Leeds Teaching Hospitals NHS Trust)
LEEDS LS1 3EX
Tel 0113 392 3945
Fax 0113 233 5672
http://www.leedsteachinghospitals.com
------ACB discussion List Information--------
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