Evaluation of a new rapid-diagnostic test for peritonitis in peritoneal dialysis: the PERIPLEX® device.

Abstract

In 2017, the British company MOLOGIC developed a new rapid-diagnostic test (PERIPLEX®) for the diagnosis of peritonitis in patients undergoing peritoneal dialysis. This single-use test is based on the detection in dialysate of two biomarkers of bacterial infection: Interleukin-6 (IL-6) and matrix metalloproteinase-8 (MMP-8). The test was evaluated in a prospective multicenter study including 10 centers from the RDPLF (French Language Peritoneal Dialysis Registry). A total of 184 tests were performed; 86 tests were negative and 98 were positive. 85 peritonitis were confirmed. There were no false-negatives, and 13 false-positives. Of the 13 false-positives, 7 of them were for sepsis without peritonitis, or peritoneal inflammation. The performance of the test is considered excellent: sensitivity 100%, specificity 86.9%, positive predictive value 86.7%, negative predictive value 100%. In this study, a negative test can formally rule out the diagnosis of peritonitis.

Diagnostic Accuracy of MMP-8 and IL-6-Based Point-of-Care Testing to Detect Peritoneal Dialysis-Related Peritonitis: A Single-Center Experience

“…Our study showed higher diagnostic accuracy for the MMP-8 and IL-6-based POCT compared to previously evaluated urinary strips [34,44]. The PERiPLEX ® system utilizes a lateral flow assay to MMP-8 and IL-6, utilizing peritoneal dialysate derived from a dialysis effluent as significant inflammatory indicators with high concentrations during sepsis cases [29,45].…”

“…Consequently, MMP-8 and IL-6-based POCT might be superior to urinary strips in detecting PDRP, rapidly diagnosing or excluding PDRP, and preventing delays in initiating antibiotic therapy [ 17 ]. An evaluation of PERiPLEX ® yielded identical values for sensitivity and a negative predictive value but lower specificity and positive predictive value (88%) [ 44 ]. Taken together, our analysis, viewed in conjunction with previous investigations, suggests that the PERiPLEX ® POCT might be beneficial in the early detection of PDRP.…”

Point-of-Care Testing: Home Is Where the Lab Is

“…New POC technology has been used for the diagnosis of peritonitis in peritoneal dialysis (PD) patients 7 .…”

“…New POC technology has been used for the diagnosis of peritonitis in peritoneal dialysis patients (7). Although not yet trialed at home, if successful, it could aid in the triage of which patients require hospital attendance, and it could avoid unnecessary travel and anxiety for those who do not.…”

Wearables in Nephrology: Fanciful Gadgetry or Prêt-à-Porter?

“…Within nephrology, point-of-care testing (POCT) at home has recently received significant interest for a variety of applications [ 3 , 4 , 5 , 6 ]. However, none of these approaches currently exist in wearable form.…”