Leukocyte esterase reagent strip as a bedside tool to detect peritonitis in patients undergoing acute peritoneal dialysis

Rathore, Vinay; Joshi, Harshal; Kimmatkar, Piyush; Malhotra, Vinay; Dk, Agarwal; Beniwal, Pankaj; Dawra, Romika; Gupta, Pooja

doi:10.4103/1319-2442.220875

Cited by 7 publications

(9 citation statements)

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“…Therefore, unless some improvement in this respect is made, it is to be expected that at least for the users of some dipstick manufacturers, the ability to detect UTI will remain less that acceptable. This is even more worrying, given the fact that positive leukocytes in extravascular fluids such as ascites and synovial fluid have recently been proposed as useful indication for some conditions like spontaneous bacterial peritonitis and periprosthetic joint infection, respectively ( 18 - 22 ).…”

Section: Discussionmentioning

confidence: 99%

Analytical verification of 12 most commonly used urine dipsticks in Croatia: comparability, repeatability and accuracy

Vuljanić¹,

Dojder²,

Špoljarić³

et al. 2018

Biochem. med. (Online)

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IntroductionVariability among manufacturers of urine dipsticks, respective to their accuracy and measurement range, may lead to diagnostic errors and thus create a serious risk for the patient. Our aims were to determine the level of agreement between 12 most commonly used urine dipsticks in Croatia, examine their accuracy for glucose and total protein and to test their repeatability.Materials and methodsA total of 75 urine samples were used to examine comparability and accuracy of 12 dipstick brands (Combur 10 TestM, ChoiceLine 10, Combur 10 TestUX, ComboStik 10M, ComboStik 11M, CombiScreen 11SYS, CombiScreen 10SL, Combina 13, Combina 11S, Combina 10M, UriGnost 11, Multistix 10SG). Agreement between each dipstick and the reference (Combur 10 TestM) was expressed as kappa coefficient (acceptable κ ≥ 0.80). Accuracy for glucose and total protein was tested by comparison with quantitative measurements on analysers: AU400 (Beckman Coulter, USA), Cobas 6000 c501 (Roche Diagnostics, Germany) and Architect plus c4000 (Abbott, USA). Repeatability was assessed on 20 replicates (acceptable > 90%).ResultsBest agreement was achieved for glucose, total protein and nitrite (11/11, k > 0.80) and the lowest for bilirubin (5/5, k < 0.60). Sensitivities for total protein were 41-75% (AU400) and 56-92% (Cobas and Architect); while specificities were 41-75% (AU400, Cobas, Architect). Dipsticks’ sensitivity and specificity for glucose were 68-98%. Most of the dipsticks showed unacceptable repeatability (6/12, < 90%) for one parameter, most prominently for pH (3/12, < 90%).ConclusionsMost commonly used dipsticks in Croatia showed low level of agreement between each other. Moreover, their repeatability varies among manufacturers and their accuracy for glucose and proteins is poor.

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Section: Discussionmentioning

confidence: 99%

Analytical verification of 12 most commonly used urine dipsticks in Croatia: comparability, repeatability and accuracy

Vuljanić¹,

Dojder²,

Špoljarić³

et al. 2018

Biochem. med. (Online)

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“…Studies have also been done to assess whether these strips can be used to detect the presence of leukocytes in peritoneal dialysate [14][15][16]. Recently, Rathore et al [17] assessed the efficacy of the strips to diagnose peritonitis in a prospective study in a single center. They followed a total of 166 patients, and 21 patients were diagnosed to have peritonitis during the study period.…”

Section: Advances In Confirmatory Test and The Advent Of Point-of-care Testingmentioning

confidence: 99%

“…This was compared to the 145 cases without peritonitis, of which only seven cases tested positive. Overall, the authors reported that the strips have a sensitivity, specificity, positive predictive value, and negative predictive value of 95.2%, 95.2%, 74.1%, and 99.3%, respectively [ 17 ]. These values were comparable to the diagnostic performance for cases based on clinical signs or total cell count.…”

Section: Advances In Confirmatory Test and The Advent Of Point-of-car...mentioning

confidence: 99%

Recent advances in novel diagnostic testing for peritoneal dialysis-related peritonitis

Fung

2022

Kidney Res Clin Pract

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Peritoneal dialysis-related peritonitis remains a significant complication and an important cause of technique failure. Based on current International Society for Peritoneal Dialysis guidelines, diagnosis of peritonitis is made when two of the three following criteria are met: 1) clinical features consistent with peritonitis; 2) dialysis effluent white blood cell count of >100 cells/μL; 3) positive effluent culture. However, early and accurate diagnosis can still be faulty, and emphasis has been placed on improving the timeliness and accuracy of diagnosis to facilitate early effective treatment. There have been advances in the novel diagnostic tests such as point-of-care molecular tests, genetics sequencing, mass spectrometry, and machine learning algorithm with immune fingerprinting. This article will discuss the latest evidence and updates of these tests in the management of peritoneal dialysis-related peritonitis.

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“…La lecture colorimétrique à l'oeil est imprécise, et peut donner lieu à des interprétations différentes. Utilisées pour le diagnostic des péritonites en dialyse péritonéale, les bandelettes urinaires donnent des résultats inconstants dans la littérature, avec une sensibilité variant de 80 à 100 % selon les études, et une spécificité variant de 45 à 95 % [5][6][7][8].…”

Section: Introductionunclassified

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

Durand¹,

Verger

2020

Bull Dial Domic

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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.

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Leukocyte esterase reagent strip as a bedside tool to detect peritonitis in patients undergoing acute peritoneal dialysis

Cited by 7 publications

References 0 publications

Analytical verification of 12 most commonly used urine dipsticks in Croatia: comparability, repeatability and accuracy

Analytical verification of 12 most commonly used urine dipsticks in Croatia: comparability, repeatability and accuracy

Recent advances in novel diagnostic testing for peritoneal dialysis-related peritonitis

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

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