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. 2024 May 27;14(11):1113.
doi: 10.3390/diagnostics14111113.

Diagnostic Accuracy of MMP-8 and IL-6-Based Point-of-Care Testing to Detect Peritoneal Dialysis-Related Peritonitis: A Single-Center Experience

Rania Ibrahim  1   2 , Mido Max Hijazi  3 , Fadwa AlAli  1 , Abdullah Hamad  1 , Ahlam Bushra  1 , Lutz Mirow  4 , Timo Siepmann  2   5
Affiliations

Diagnostic Accuracy of MMP-8 and IL-6-Based Point-of-Care Testing to Detect Peritoneal Dialysis-Related Peritonitis: A Single-Center Experience

Rania Ibrahim et al. Diagnostics (Basel). .

Abstract

Background: Peritoneal dialysis-related peritonitis (PDRP) is the most common complication of peritoneal dialysis (PD), which can lead to poor outcomes if not diagnosed and treated early. We aimed to investigate the diagnostic accuracy of MMP-8 and IL-6-based point-of-care tests (POCTs) in diagnosing PDRP in PD patients.

Methods: This retrospective chart review study was conducted at a comprehensive kidney center in Qatar. It involved all adult PD patients who underwent PDRP from July 2018 to October 2019 and for whom MMP-8 and IL-6-based POCTs were used to diagnose presumptive peritonitis. Measures of diagnostic accuracy were computed. Peritoneal fluid effluent analysis was the reference standard.

Results: We included 120 patients (68 [56.7%] females, ages 55.6 ± 15.6 years, treatment duration 39.5 ± 30.4 months [range: 5-142 months]). In this population, MMP-8 and IL-6-based POCTs yielded 100% in all dimensions of diagnostic accuracy (sensitivity, specificity, positive and negative predictive values).

Conclusions: MMP-8 and IL-6-based POCTs might be helpful in the early detection of PDRP. This monocentric observation requires further confirmation in a prospective multicentric setting.

Keywords: biomarkers; diagnostic accuracy; end-stage renal disease; matrix metalloproteinase-8; peritoneal dialysis; peritoneal dialysis-related peritonitis; point-of-care testing.

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Conflict of interest statement

Author “Lutz Mirow” was employed by the company “Klinikum Chemnitz gGmbH” and declares no conflict or potential commercial of financial conflict. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram for PD patients’ identification and screening for PDRP in Qatar between (July 2018 and October 2019). (PDRP) peritoneal dialysis-related peritonitis; (TLC) total leukocyte count. Index test: This evaluates MMP-8 and IL-6-based POCT for its accuracy, sensitivity, and specificity to detect or roll out peritoneal dialysis-related peritonitis. Reference test: This is the gold standard for diagnosing peritoneal dialysis-related peritonitis. According to the International Society of Peritoneal Dialysis (ISDP) guidelines, it is considered the most accurate and reliable diagnostic test.
Figure 2
Figure 2
The clinical pathway outlines the diagnostic protocol for suspected patients with peritoneal dialysis-related peritonitis (PDRP). WBC: White blood cells, CRP: C-reactive protein.
Figure 3
Figure 3
The empirical antibiotic treatment protocol against Gram-positive and Gram-negative microorganisms for suspected patients with PDRP. IP: Intraperitoneal Cavity.
Figure 4
Figure 4
The application of MMP-8 and IL-6-based POCT at bedside (Artwork by R. Ibrahim). Created with BioRender.com.
Figure 5
Figure 5
Interpretation of the test results displayed in the device window (Artwork by R. Ibrahim). Created with BioRender.com.
See this image and copyright information in PMC

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