Goodlad, Catriona, George, Sophiamma, Sandoval, Shella, Mepham, Stephen, Parekh, Gita, Eberl, Matthias  ORCID: https://orcid.org/0000-0002-9390-5348, Topley, Nicholas and Davenport, Andrew
2020.
Measurement of innate immune response biomarkers in peritoneal dialysis effluent using a rapid diagnostic point-of-care device as a diagnostic indicator of peritonitis.
Kidney International
97
(6)
, pp. 1253-1259.
10.1016/j.kint.2020.01.044
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Abstract
Peritonitis is the commonest complication of peritoneal dialysis and a major reason for treatment failure. Current diagnosis is based on clinical symptoms, cloudy effluent and a dialysate white cell count (over 100 cells/μl). A rapid point-of-care diagnostic test would accelerate diagnosis and potentially improve outcomes from infection. Here, in a clinical audit project, we used PERiPLEX®, a point-of-care device which detects when levels of matrix metalloproteinase-8 and interleukin-6 are elevated above a threshold within minutes in dialysis effluent, to assess whether it could confirm or exclude peritonitis in 107 patients undergoing peritoneal dialysis. Mean patient age was 64.6 years with a median duration of peritoneal dialysis of 3.5 months (interquartile range 6.4 – 31.5 months). Presence of peritonitis was confirmed by clinical criteria. There were 49 positive tests of which 41 patients had peritonitis, three had other causes of intra-peritoneal inflammation, three had severe urosepsis and two patients required no treatment. Fifty eight tests were negative with one patient having a false negative result. The positive predictive value of the test was 83.7% (95% confidence interval 72.8 – 90.8) and the negative predictive value was 98.3% (89.1 – 99.8). Sensitivity and specificity were 97.6% (87.4 – 99.9) and 87.7% (77.2 – 94.5) respectively. Thus, PERiPLEX® could be used as a rapid point-of-care test that can aid the diagnosis or exclusion of peritonitis with a high negative predictive value.
| Item Type: | Article |
|---|---|
| Date Type: | Publication |
| Status: | Published |
| Schools: | Schools > Medicine |
| Publisher: | Elsevier |
| ISSN: | 0085-2538 |
| Date of First Compliant Deposit: | 30 March 2020 |
| Date of Acceptance: | 30 January 2020 |
| Last Modified: | 21 Nov 2024 13:30 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/130632 |
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