TY  - JOUR
SP  - 1253
SN  - 0085-2538
JF  - Kidney International
AV  - public
KW  - biomarkers
KW  -  infection diagnosis
KW  -  peritoneal dialysis
KW  -  peritonitis
KW  -  point-of-care
IS  - 6
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
TI  - Measurement of innate immune response biomarkers in peritoneal dialysis effluent using a rapid diagnostic point-of-care device as a diagnostic indicator of peritonitis
Y1  - 2020/06//
A1  - Goodlad, C
A1  - George, S
A1  - Sandoval, S
A1  - Mepham, S
A1  - Parekh, G
A1  - Eberl, M
A1  - Topley, N
A1  - Davenport, A
VL  - 97
UR  - https://doi.org/10.1016/j.kint.2020.01.044
N2  - 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/?l). 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 13.3 months (interquartile range 6.3 ? 33.5 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.
EP  - 1259
ID  - discovery10097115
ER  -