Abstract
The estimation of electrolytes like sodium (Na+), potassium (K+) and chloride (Cl−) using direct and indirect ion-selective electrodes (ISE) is a routine laboratory practice. Interferents like proteins, triglycerides, drugs etc. are known to affect the results. The present study was designed to look into the effect of increasing glucose concentrations on estimation of Na+, K+ and Cl− by direct and indirect ISE. Pooled sera was mixed with glucose stock solution (20 g/dL) prepared in normal saline to obtain glucose concentrations ranging from ~100 to ~5000 mg/dL. Na+, K+ and Cl− levels were estimated by direct and indirect ISE analyzers and results were statistically analysed using ANOVA and Pearson’s correlation. Similar experiment was also performed in 24 h urine sample from healthy subjects. Significant difference was observed between Na+ and Cl− measurements by direct and indirect ISE, with indirect ISE values being consistently higher than direct ISE. Besides this, significant difference was observed amongst Na+ and Cl− values from baseline values obtained by indirect ISE at glucose concentrations ≥2486 mg/dL. However, no such difference was observed with direct ISE. Na+ and Cl− estimation by indirect ISE showed significant negative correlation with glucose concentration, more so, above ~2000 mg/dL. K+, however, showed no significant difference with varying glucose. Similar results were observed in 24 h urine samples with a significant difference observed amongst Na+ and Cl− values at ≥2104 mg/dL glucose. Thus we conclude that high glucose concentrations interfere significantly in estimation of Na+ and Cl− by indirect ISE in serum as well as urine.
Similar content being viewed by others
References
Tietz NW, Pruden EL, Siggaard-Andersen O. Electrolytes. In: Burtis CA, Ashwood ER, editors. Tietz fundamental of clinical chemistry. 4th ed. Philadelphia: WB Saunders; 2006. p. 95–101.
Albert V, Subramanian A, Rangarajan K, Pandey RM. Agreement of two different laboratory methods used to measure electrolytes. J Lab Phys. 2011;3:104–9.
Nguyen MK, Ornekian V, Butch AW, Kurtz I. A new method for determining plasma water content: application in pseudohyponatremia. Am J Physiol Renal Physiol. 2007;292:F1652–6.
Dimeski G, Mollee P, Carter A. Effects of hyperlipidemia on plasma sodium, potassium, and chloride measurements by an indirect ion-selective electrode measuring system. Clin Chem. 2006;52:155–6.
Al-Musheifri A, Jones GR. Glucose interference in direct ion-sensitive electrode sodium measurements. Ann Clin Biochem. 2008;45:530–2.
Levy GB. Determination of sodium with ion-selective electrodes. Clin Chem. 1981;27:1435–8.
Dimeski G, Badrick T, John AS. Ion selective electrodes (ISEs) and interferences-a review. Clin Chim Acta. 2010;411:309–17.
Dimeski G, Barnett RJ. Effects of total plasma protein concentration on plasma sodium, potassium and chloride measurements by an indirect ion selective electrode measuring system. Crit Care Resusc. 2005;7:12–5.
Twomey PJ, Cordle J, Pledger DR, Miao Y. An unusual case of hyponatraemia in diabetic ketoacidosis. J Clin Pathol. 2005;58:1219–20.
Sbrignadello Stefano, Tura Andrea, Ravazzani Paolo. Electroimpedance spectroscopy for the measurement of the dielectric properties of Na+Cl− solutions at different glucose concentrations. J Spectros. 2013. doi:10.1155/2013/571372.
Mayes HB, Tian J, Nolte MW, Shanks BH, Beckham GT, Gnanakaran S, et al. Sodium ion interactions with aqueous glucose: insights from quantum mechanics, molecular dynamics, and experiment. J Phys Chem B. 2014;118:1990–2000.
Frant MS, Ross JW Jr. Potassium ion specific electrode with high selectivity for potassium over sodium. Science. 1970;167:987–8.
Rumenjak V, Milardovic S, Kruhak I, Grabaric BS. The study of some possible measurement errors in clinical blood electrolyte potentiometric (ISE) analysers. Clin Chim Acta. 2003;335:75–81.
Wang T, Diamandis EP, Lane A, Baines AD. Variable selectivity of the Hitachi chemistry analyzer chloride ion-selective electrode toward interfering ions. Clin Biochem. 1994;27:14–37.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflict of interests.
Ethical Standards
There was no involvement of any direct human or animal subjects in any experiments in the study. All procedures performed in the study involving samples from human origin were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study has also been approved by the Ethical Committee of PGIMER, Chandigarh no NK/2341/Study/4727.
Additional information
Bela Goyal and Sudip Kumar Datta have contributed equally to the manuscript.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Goyal, B., Datta, S.K., Mir, A.A. et al. Increasing Glucose Concentrations Interfere with Estimation of Electrolytes by Indirect Ion Selective Electrode Method. Ind J Clin Biochem 31, 224–230 (2016). https://doi.org/10.1007/s12291-015-0522-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12291-015-0522-0