THE ACCURACY OF LEUKOCYTE ESTERASE URINE STRIP FOR DIAGNOSIS OF PERITONITIS IN PATIENTS ON PERITONEAL DIALYSIS

Abstract

Background: Peritonitis is a major complication in peritoneal dialysis (PD) patients, leading to treatment failure, shifting mode of dialysis or death. The rapid initial diagnosis allows patients to receive early treatment.

 Objective To compare  the efficacy of leukocyte esterase (LE) urine strip test and White blood cell (WBC) count by conventional light microscopy method in peritoneal dialysate fluid  (PDF) for diagnosis of  PD-related peritonitis in PD patients.

Method: Diagnostic accuracy  research  with prospective data collection process  in continuous ambulatory peritoneal dialysis (CAPD) patients at Pakchong Nana hospital, who were admitted to the hospital or  suspected for peritonitis or had risk factors of peritonitis  e.g. contact contamination. A total of 30 patients was included. 326 PDF samples were collected. Each sample was dipped by LE urine strip and sent to the laboratory for White blood cell (WBC) counts by light microscopy for PD-related peritonitis diagnosis. Determine the sensitivity, specificity and accuracy of the urine strip test with conventional light microscopy method.

Results: The LE urine strip had the sensitivity of 85.71%, specificity of 87.19%, positive predictive value of 69.90%, negative predictive value of 94.62%, accuracy value of 86.81%. There was a significant positive correlation between LE strips result  V.S. WBC count  in PDF,  percentage of neutrophils in PDF, absolute neutrophil count in PDF with Spearman's correlation coefficient rho of 0.679 , 0.627 and 0.680 respectively with p<0.001 in all 3 variables.

Conclusion and recommendation:

The utility of leukocyte esterase urine strip for diagnosis of peritoneal dialysate fluid with result of 2+ or  3+, were  tools for early diagnose PD  related peritonitis, that allows patients to receive earlier treatment before the laboratory reports.