Glucose interference in direct ion-sensitive electrode sodium measurements

Ann Clin Biochem 2008;45:530-532
doi:10.1258/acb.2008.008001
© 2008 Association for Clinical Biochemistry

 

 

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Case Reports


Asila Al-Musheifri and
Graham R D Jones


Department of Chemical Pathology, St Vincent’s Hospital, Victoria St Darlinghurst, Sydney, NSW 2010, Australia


Corresponding author: Dr Graham R D Jones. Email: gjones{at}stvincents.com.au

Circulating sodium concentration is commonly measured by both direct and indirect ion-sensitive electrode (ISE). We describe an unusual case with a high elevation of serum glucose (162 mmol/L) where direct ISE sodium measurement was 9 mmol/L higher than the indirect measurement in the absence of any cause for pseudohyponatraemia. In vitro experiments showed that very highglucose concentrations increased the sodium in direct, but notin indirect ISE measurement. This effect was insufficient toaccount for the entire difference between the measurements seenin the patient, indicating that other factors, for example pHand bicarbonate concentration, must also be involved. This effectmay influence interpretation of sodium status in patients withgross hyperglycaemia.


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