Early detection of peritonitis in continuous ambulatory peritoneal dialysis patients by use of chemiluminescence: evaluation of diagnostic accuracy by receiver-operating characteristic curve analysis

Early detection of peritonitis in continuous ambulatory peritoneal dialysis patients by use of chemiluminescence: evaluation of diagnostic accuracy by receiver-operating characteristic curve analysis

Continuous ambulatory peritoneal dialysis (CAPD) is now a widely accepted treatment for end-stage renal disease. However, the high incidence of peritonitis is a major complication of CAPD. Polymorphonuclear leukocytes (PMNs) play a major role in antimicrobial response of the host. During phagocytosi...

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Bibliographic Details
Published in:Clinical chemistry (Baltimore, Md.) Vol. 44; no. 8; pp. 1680 - 1684
Main Authors: Dalaman, Gonul, Haklar, Goncagul, Sipahiu, Armand, Ozener, Cetin, Akoglu, Emel, Yalcin, A. Suha
Format: Journal Article
Language:English
Published: Washington, DC Am Assoc Clin Chem 01-08-1998
American Association for Clinical Chemistry
Subjects:
Acridines - analysis
Adolescent
Aged
Biological and medical sciences
Child
Child, Preschool
Dialysis Solutions - chemistry
Digestive system
Female
Humans
Investigative techniques, diagnostic techniques (general aspects)
Kidney Failure, Chronic - therapy
Luminescent Measurements
Luminol - analysis
Male
Medical sciences
Middle Aged
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Peritoneal Dialysis, Continuous Ambulatory - adverse effects
Peritonitis - diagnosis
Peritonitis - etiology
ROC Curve
Sensitivity and Specificity
Human
Cytologic investigation
Granulocyte
Chemiluminescence
Medical screening
Peritoneal dialysis
Infection
Extrarenal dialysis
Abdominal disease
Laboratory investigations
Clinical biology
Complication
Ambulatory
Diagnosis
Peritonitis
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Summary:Continuous ambulatory peritoneal dialysis (CAPD) is now a widely accepted treatment for end-stage renal disease. However, the high incidence of peritonitis is a major complication of CAPD. Polymorphonuclear leukocytes (PMNs) play a major role in antimicrobial response of the host. During phagocytosis, the PMNs undergo a striking increase in oxidative metabolism, known as the respiratory burst, and emit light as chemiluminescence (CL). CL is thus a sensitive measure of PMN oxidative potential and correlates well with antimicrobial activity. In view of the observation of increased susceptibility to infection in CAPD patients, we have studied lucigenin- and luminol-enhanced CL in peritoneal fluids of these patients and assessed the diagnostic accuracy of these tests by ROC curve analysis. ROC curves showed diagnostic accuracies for both tests that were superior to counts of PMNs in the dialysis fluid (P <0.001). At selected cutoff values of 150000 cpm/vial for lucigenin CL and 600000 cpm/vial for luminol CL, sensitivities were 100%. Specificities for lucigenin and luminol CL were 89% and 80%, respectively. Our results suggest that CL measurements can be used as an early marker for the presence of infection in CAPD patients.
Bibliography:ObjectType-Article-2
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content type line 23
ISSN:0009-9147
1530-8561
DOI:10.1093/clinchem/44.8.1680