Evaluation of a new rapid-diagnostic test for peritonitis in peritoneal dialysis: the PERIPLEX® device.
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.
Davenport A. Peritonitis remains the major clinical complication of peritoneal dialysis : the London, UK, peritonitis audit 2002-2003. Perit Dial Int 2009; 29: 297-302.
Statistiques 2018, site officiel RDPLF. https://rdplf.org/resultatsrdplf/epidemiologie-dialyse-peritoneale.html
Verger C, Fabre E, Veniez G, Padernoz MC. Synthetic 2018 data report of the French Language Peritoneal Dialysis and Home Hemodialysis Registry (RDPLF). Bull Dial Domic [Internet]. 2019; Apr.10 [cited 2020Aug.1];2(1):1-10. Available from: https://doi.org/10.25796/bdd.v2i1.19093
Li PK, Szeto CC, Piraino B, et al. ISPD peritonitis recommendations : 2016 update on prevention and treatment. Perit Dial Int 2016; 36: 481-508.
Cropper E, Coleclough S, Griffiths S, et al. Rapid diagnosis of peritonitis in peritoneal dialysis patients. J Nephrol 2003; 16(3): 379-383.
Moral MN, Martinez-Camblor P, Mendez-Gonzalez A, et al. MUL+DO: a multicomponent indexxx for the quick diagnosis of peritonitis in peritoneal dialysis patients. Nefrologia 2018; 38: 273-278.
Rathore V, Joshi H, Kimmatkar PD, et al. Leukocyte esterase reagent strip as bedside tool to detect peritonitis in patients undergoing acute peritoneal dialysis. Saudi J Kidney Dis Transpl 2017; 28(6): 1264-1269.
Fan S, Lane C, Punzalan S. Correlation of periscreen strip results and white cell count in peritoneal dialysis peritonitis. J Ren Care 2010; 36(2): 90-95.
Yang X, Tong Y, Yan H, et al. High intraperitoneal Interleukin-6 levels predict peritonitis in peritoneal dialysis patients : a prospective cohort study. Am J Nephrol 2018; 47(5): 317-324.
Goodlab C, George S, Sandoval S, et al. Measurement of innate immune response biomarkers in peritoneal dialysis effluent using a rapid diagnostic point-of-care device as a diagnostic indicator of peritonitis. Kidney Int 2020; 6: 1253-1259.
Verger C, Veniez G, Dratwa M. Variability of aseptic peritonitis rates in the RDPLF. Bull Dial Domic [Internet]. 2018; Jun.13 [cited 2020Aug.1];1(1):9-13. Available from: https://doi.org/10.25796/bdd.v1i1.30
Grillon A, Boyer PH, Heibel F. Bacteriological sampling of peritoneal dialysis fluids. How to limit negative-culture peritonitis rate?. Bull Dial Domic [Internet]. 2018; Jun.13 [cited 2020Aug.1];1(1):15-9. Available from: https://doi.org/10.25796/bdd.v1i1.20
Atkinson SJ, Nolan M, Klingbeil, et al. Intestine-derived matrix metalloprotease-8 is a critical mediator of polymicrobial peritonitis. Crit Care Med 2016; 44: e200-206.
Zhang J, Friberg IM, Kift-Morgan A, et al. Machine-learning algorithms define pathogen-specific local immune fingerprints in peritoneal dialysis patients with bacterial infections. Kidney Int 2017; 92: 179-191.
Cho JH, Hur IK, Kim CD, et al. Impact of systemic and local peritoneal inflammation on peritoneal solute transport rate in new peritoneal dialysis patients: a 1-year prospective study. Nephrol Dial Transplant 2010; 25: 1964-1973.
Li PK, Ng JK, McIntyre CW. Inflammation and peritoneal dialysis. Semin Nephrol 2017; 37: 54-65.
Copyright (c) 2020 Pierre-Yves Durand, Christian Verger
This work is licensed under a Creative Commons Attribution 4.0 International License.