Evaluation of a card test for procalcitonin in continuous ambulatory peritoneal dialysis peritonitis

2007 ◽  
Vol 44 (5) ◽  
pp. 482-484 ◽  
Author(s):  
Fatma Meriç Yilmaz ◽  
Gülsen Yilmaz ◽  
Hatice Akay ◽  
Murat Duranay ◽  
Doğan Yücel
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Clinical Signs ◽  
High Specificity ◽  
Reactive Protein ◽  
Potential Marker ◽  
Wbc Count ◽  
Low Sensitivity ◽  
Laboratory Sign ◽  
Card Test

Background: Peritonitis is an important complication in continuous ambulatory peritoneal dialysis (CAPD) patients. Procalcitonin (PCT) has recently been identified as an inflammation marker and recommended as a new potential marker in CAPD peritonitis. We aimed to study a card test for PCT and compare the results with the conventional markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count. Patients and methods: A total of 40 CAPD patients; 20 patients with an episode of peritonitis and 20 patients without any clinical or laboratory sign of infection were included in the study. PCT, CRP, ESR, WBC and dialysate cell count were performed at the beginning of the clinical signs of peritonitis. Results: CRP and ESR had the highest sensitivities (100% for both) but lower specificities (55 and 10%; respectively) and PCT had the highest specificity with a relatively low sensitivity (100 and 70%) according to the calculated results. Conclusions: The card test for PCT seems to be suitable for the adjunctional use in CAPD peritonitis, with its shorter turn-around time, appropriateness for near-patient testing and high specificity.

Leukocytes in Peritoneal Dialysis Effluents

1991 ◽  
Vol 11 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Steen Antonsen ◽  
Fritz B. Pedersen ◽  
Palle Wang ◽  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Leukocyte Count ◽  
Clinical Signs ◽  
Neutrophil Granulocytes ◽  
And Storage ◽  
Leukocyte Concentration

The concentration of leukocytes and the fraction of neutrophil granulocytes are two important criteria in the diagnosis of peritonitis in continuous ambulatory peritoneal dialysis (CAPD). We have found that leukocytes are unstable in dialysis effluents, resulting in false low leukocyte concentrations if not counted immediately. At 25°C the leukocyte count decreases 25%–30% in 4–6 hours. Sampling in tubes containing EDTA and storage at 4°C make the leukocyte concentration stable for 6 hours, while the combination of EDT A and storage at 4°C ensures stability for 24 hours. When samples are handled accordingly, concentrations as high as 2 × 108/L are observed without any clinical signs of peritonitis, especially within the first months of CAPD-treatment. Thus, we suggest a leukocyte-concentration of 2 × 1 08/L as the diagnostic limit for peritonitis. Concerning fraction of neutrophils a diagnostic limit of 0.50 still seems relevant.

C-Reactive Protein and Anti-Chlamydia Pneumoniae Antibodies as Risk Factors of Cardiovascular Death in Incident Patients on Peritoneal Dialysis

2003 ◽  
Vol 23 (2) ◽  
pp. 132-137 ◽  
Author(s):  
Ramón Paniagua ◽  
Yolanda Frías ◽  
Maria De Jesús Ventura ◽  
Ernesto Rodríguez ◽  
María Elena Hurtado ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Chlamydia Pneumoniae ◽  
Clinical Signs ◽  
Cardiovascular Death ◽  
Serum Glucose ◽  
C Reactive Protein ◽  
Reactive Protein

Objective Recently it has been pointed out that inflammation and infections caused by germs such as Chlamydia pneumoniae are independent cardiovascular risk factors for the general population, but information about these relationships in dialysis patients is scarce. This work was done to analyze the association of C-reactive protein (CRP) and IgG anti- Chlamydia pneumoniae antibodies (anti-Chlp-IgG) as independent cardiovascular risk factors in incident patients on continuous ambulatory peritoneal dialysis (CAPD). Design Single-cohort, prospective observational study. Setting Three CAPD centers from the Instituto Mexicano del Seguro Social, and one from the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico. Patients A cohort of 75 adult incident patients on CAPD, without clinical signs of congestive heart failure, coronary heart disease, or peripheral arterial insufficiency. No restrictions for age, gender, or cause of renal failure were applied. Primary Outcome Mortality. Methods Demographic variables, body composition by electrical bioimpedance, serum glucose, urea, creatinine, lipids, homocysteine, nutritional markers (albumin, prealbumin, and transferrin), CRP, and anti-Chlp-IgG were measured and registered at the time of the first admission. When a patient died, the cause of death was determined by review of the clinical chart. Results Mean follow-up time was 10.25 patient-months. There were 14 cardiovascular deaths. CRP was positive (> 10 mg/L) in 64% of the patients, and anti-Chlp-IgG in 64%; 29% of the patients were positive for both markers. The relative risk for cardiovascular mortality was 6.23 for patients positive for either CRP or anti-Chlp-IgG, and increased to 9.52 when both markers were positive. Multivariate analysis revealed that CRP and anti-Chlp-IgG were stronger cardiovascular death predictors than age, diabetes, and nutritional status. Conclusion These data suggest that inflammation and the presence of Chlamydia pneumoniae infections are important predictors of cardiovascular death in patients on CAPD.

Serum C-Reactive Protein: A Predictor of Mortality in Continuous Ambulatory Peritoneal Dialysis Patients

1998 ◽  
Vol 18 (4) ◽  
pp. 387-394 ◽  
Author(s):  
Hyunjin Noh ◽  
Seoung Woo Lee ◽  
Shin Wook Kang ◽  
Sug Kyun Shin ◽  
Kyu Hun Choi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Survival Rate ◽  
Outcome Measures ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Patient Survival Rate

Objective To evaluate the predictive value of a single baseline serum C-reactive protein (sCRP) as a marker of mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. Design A review of prospectively collected data in a 2-year follow-up study. Setting Tertiary medical center. Patients The study included 106 patients who were stable and had been on CAPD for a minimum of 3 months. Main Outcome Measures Patient survival rate was the main outcome measure of this study. Other outcome measures were technique survival rate, peritonitis rate, and hospitalized days. Covariables used in the survival analysis were age, sex, the presence of cardiovascular disease or diabetes mellitus, sCRP, serum albumin, hematocrit, cholesterol, HDL-cholesterol, malnutrition by subjective global assessment (SGA), weekly Kt/V urea, and weekly standardized creatinine clearance (SCCr). Results The 2-year patient survival rate was significantly lower in the increased sCRP group than in the normal sCRP group (66.7% vs 94.1%, p = 0.001), although there was no significant difference in technique failure, peritonitis rate, and hospitalized days between the two groups. By Cox proportional hazards analysis, independent predictors of mortality were: cardiovascular disease (relative risk, RR = 8.96, p < 0.005); increased sCRP level (RR = 1.19, p < 0.05); and high hematocrit (RR = 1.18, p < 0.05). ← Conclusion Serum CRP at enrollment is an independent predictor of 2-year patient survival in CAPD patients.

scholarly journals Citrulline as a biomarker of short bowel syndrome in children

2020 ◽  
Vol 9 (4) ◽  
pp. 35-42
Author(s):  
K. Y. Marakhouski ◽  
A. A. Svirsky ◽  
A. M. Makhlin ◽  
N. D. Shmeleva ◽  
Z. I. Kuvaeva ◽  
...  
Keyword(s):  
Short Bowel Syndrome ◽  
High Performance ◽  
Clinical Signs ◽  
High Specificity ◽  
Control Group ◽  
Diagnostic Significance ◽  
Short Bowel ◽  
Citrulline Level ◽  
Low Sensitivity ◽  
Children Under 5

Purpose. To determine the diagnostic significance of blood citrulline level when estimating the short bowel syndrome (SBS) in children under 5 years old. To determine the blood citrulline level in children of different age. Methods. The examined group (N=31) included children under 5 who underwent small or small and large intestine resection and developed (15 children) or not developed (16 children) clinical signs of SBS. The control group included children who underwent no surgery on the GIT and had no congenital malformations and clinical signs of enteropathy (N=42). To determine the level of citrulline, overpressured high performance liquid column chromatography was used. Statistical analysis of the results was done with MedCalc® version 18.11.3. Results. Mean level of blood citrulline is 28.9 µmol/l in the examined group (95% CI 23.2–34.6) and 30.5 µmol/l in the control group (95% CI 25.0–35.1). Reliable data of the ratio between blood level citrulline and age of the child were obtained both among operated and non-operated children. The odds ratio of determining citrulline in blood was below 24.4 µmol/l in development of SBS clinical picture and amounted to 4.08 р < 0,05. Additional use of ROC analysis confirms the presence of interrelation between citrulline level and absence or presence of SBS clinical signs with 100% specificity and 43% sensitivity. The area under curve (categorical variable showing whether SBS is present or lacking) is 0,746, р = 0,005. Conclusion. Determination of serum citrulline as a diagnostic marker of short bowel syndrome in children under 5 found low sensitivity but high specificity. Thus, blood citrulline index can be used as a biomarker to diagnose SBS, to describe the course of SBS in detail and determine the risk of severe forms of this pathology in children under 5.

scholarly journals The utility of Coccidioides antigen and antibody detection in cerebrospinal fluid in the diagnosis of canine central nervous system coccidioidomycosis

2022 ◽  
pp. 1-5
Author(s):  
Christine D. Butkiewicz ◽  
Cody J. Alcott ◽  
Janelle Renschler ◽  
Lawrence J. Wheat ◽  
Lisa F. Shubitz
Keyword(s):  
Clinical Signs ◽  
High Specificity ◽  
Antibody Detection ◽  
Antibody Testing ◽  
Endemic Region ◽  
Predictive Values ◽  
Csf Analysis ◽  
Neurologic Disorders ◽  
Low Sensitivity ◽  
A Prospective Study

Abstract OBJECTIVE To evaluate the utility of enzyme immunoassays (EIAs) for the detection of Coccidioides antigen and antibody in CSF in the diagnosis of CNS coccidioidomycosis in dogs. ANIMALS 51 dogs evaluated for CNS disease in a single specialty center in Tucson in 2016. PROCEDURES Excess CSF after routine analysis was banked after collection from dogs presented to the neurology service. Samples were tested by EIA for presence of Coccidioides antigen and antibody. Clinical data were collected from medical records retrospectively. RESULTS 22 dogs were diagnosed with CNS coccidioidomycosis (CCM) or another neurologic disease (non-CCM). These groups of dogs overlapped in the presenting complaints, MRI results, and routine CSF analysis results. Four dogs, all with CCM, had positive antigen EIA results. With clinical diagnosis used as the reference standard, CSF antigen testing had low sensitivity (20%) but high specificity (100%) for diagnosis of CCM. Ten dogs with CCM and 4 dogs with other diagnoses had antibody detected in CSF by EIA. Sensitivity of CSF antibody testing was 46%, specificity was 86%, and positive and negative predictive values for the study population were 71% and 68%, respectively. Clinical Relevance Diagnosis of CNS coccidioidomycosis in dogs in an endemic region was hampered by overlap of clinical signs with other neurologic disorders and the low sensitivity of confirmatory diagnostics. The evaluated Coccidioides-specific EIAs performed on CSF can aid in the diagnosis. A prospective study is warranted to corroborate and refine these preliminary findings

Infectious Mononucleosis in an Outpatient Population

1999 ◽  
Vol 123 (10) ◽  
pp. 875-881 ◽  
Author(s):  
Malcolm L. Brigden ◽  
Sandra Au ◽  
Susan Thompson ◽  
Sean Brigden ◽  
Patrick Doyle ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Sensitivity And Specificity ◽  
Infectious Mononucleosis ◽  
High Specificity ◽  
Control Group ◽  
Heterophile Antibody ◽  
Number Of Patients ◽  
Wbc Count ◽  
Low Sensitivity ◽  
Hematology Analyzers

Abstract Objectives.—To determine the sensitivity and specificity of 2 modern hematology analyzers in flagging heterophile-positive patients; to determine if heterophile-positive, instrument-flagged specimens contain a larger number or a different spectrum of atypical lymphocytes; to document the overall sensitivity and specificity of Hoagland's morphologic criteria in identifying heterophile-positive patients in an outpatient population with a clinical diagnosis of mononucleosis; and to examine whether individual morphologic features might aid in the diagnosis of suspected infectious mononucleosis. Design.—A prospective study of patients referred with a clinical diagnosis of infectious mononucleosis who subsequently tested positive for the heterophile antibody. The control group consisted of a similar population of patients who tested negative for the heterophile antibody. Intervention.—Hematology profiles of peripheral blood samples were determined with Coulter STKS and Sysmex NE-8000 analyzers. A corresponding Wright-Giemsa–stained blood smear was subsequently examined by a single skilled technologist, who performed a 200-cell white blood cell differential and a 200-cell lymphocyte differential. A specific morphologic search was made for the presence of smudge cells or lymphocytes with cloverleaf nuclei. Results.—Using a combination of all flagging criteria, the 2 analyzers identified 156 (86.2%) of 181 heterophile-positive patients as meriting further review. The sensitivity and specificity values of the Coulter analyzer in predicting positive heterophile status for the blast flag were 41% and 97.1%, respectively; for the variant lymphocyte flags, 72.4% and 79.1%, respectively; and for both flags, 40% and 98.1%, respectively. For the Sysmex analyzer, the sensitivity and specificity values in predicting positive heterophile status for the blast flag were 43.4% and 88.6%, respectively; for the variant lymphocyte flag, 15.8% and 90.8%, respectively; and for both flags, 10.5% and 96%, respectively. Considering the classic criteria developed by Hoagland, a lymphocytosis of at least 50% was present in 120 (66.3%) heterophile-positive patients, while an atypical lymphocytosis of at least 10% of the total WBC count was noted in 135 patients (74.6%). The sensitivity and specificity values of a lymphocytosis ≥50% for diagnosing heterophile-positive status were 66.3% and 84.5%, respectively, while the sensitivity and specificity of an atypical lymphocytosis ≥10% were 74.6% and 92.3%, respectively. The presence of smudge cells or cloverleaf lymphocyte nuclei was verified as having high specificity but low sensitivity for suggesting a diagnosis of infectious mononucleosis. Conclusion.—Although a number of patients did not meet Hoagland's criteria for the diagnosis of infectious mononucleosis, the flagging systems of modern hematology analyzers successfully identified most cases as requiring further review.

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