Stanley Fan1, Catherine Lane, Sally Punzalan. 1. Department of Renal Medicine and Transplantation, The Royal London and St Bartholomew's Hospitals, London, UK. s.fan@qmul.ac.uk
Abstract
INTRODUCTION: Monitoring of peritoneal dialysis (PD) peritonitis can be difficult for visually impaired patients. PeriScreen strips measure leukocyte esterase activity and this might be a useful objective test that can be performed by patients at home. METHODS: A prospective study of 138 episodes of peritonitis was undertaken. Effluent samples were analysed for white cell count (WCC) and PeriScreen score on days 3 and 5. Co-morbidity data were collated from these patients. RESULTS: Effluent WCC and PeriScreen results were found to correlate with the gold standard assessment of microbiology WCC count. A positive PeriScreen result on day 5 predicted that the episode of peritonitis would relapse after treatment with a sensitivity of 80% but with a poor specificity of 45%. Patients who cleared or relapsed their peritonitis could not be differentiated based on their burden of co-morbidity, Karnofsky scores, age, dialysis vintage or infective organism. CONCLUSION: PeriScreen strip analysis correlated with microscopic WCC of PD. However, analysis of PD effluent on day 5 of treatment is not a good test to risk stratify patients for relapsing peritonitis.
INTRODUCTION: Monitoring of peritoneal dialysis (PD) peritonitis can be difficult for visually impairedpatients. PeriScreen strips measure leukocyte esterase activity and this might be a useful objective test that can be performed by patients at home. METHODS: A prospective study of 138 episodes of peritonitis was undertaken. Effluent samples were analysed for white cell count (WCC) and PeriScreen score on days 3 and 5. Co-morbidity data were collated from these patients. RESULTS: Effluent WCC and PeriScreen results were found to correlate with the gold standard assessment of microbiology WCC count. A positive PeriScreen result on day 5 predicted that the episode of peritonitis would relapse after treatment with a sensitivity of 80% but with a poor specificity of 45%. Patients who cleared or relapsed their peritonitis could not be differentiated based on their burden of co-morbidity, Karnofsky scores, age, dialysis vintage or infective organism. CONCLUSION: PeriScreen strip analysis correlated with microscopic WCC of PD. However, analysis of PD effluent on day 5 of treatment is not a good test to risk stratify patients for relapsing peritonitis.
Authors: Philip Kam-Tao Li; Cheuk Chun Szeto; Beth Piraino; Javier de Arteaga; Stanley Fan; Ana E Figueiredo; Douglas N Fish; Eric Goffin; Yong-Lim Kim; William Salzer; Dirk G Struijk; Isaac Teitelbaum; David W Johnson Journal: Perit Dial Int Date: 2016-06-09 Impact factor: 1.756