ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO397

Smartphone-Based Point-of-Care Diagnostics for Early Detection of Peritonitis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Grobe, Nadja, Renal Research Institute, New York, New York, United States
  • Tao, Xia, Renal Research Institute, New York, New York, United States
  • Garbaccio, Mia Genevieve, Renal Research Institute, New York, New York, United States
  • Villarama, Maricar, RRI/Avantus, New York, New York, United States
  • Hanrahan, Christopher, RRI/Avantus, New York, New York, United States
  • Thijssen, Stephan, Renal Research Institute, New York, New York, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
Background

Peritonitis is a serious complication in peritoneal dialysis (PD) and associated with significant morbidity and mortality. Diagnostic criteria include turbid effluent with >100 leukocytes/µl, abdominal pain, and a positive culture. Since accurate diagnosis and a short time-to-treatment are essential for therapy success, we developed a smartphone-based system to measure turbidity in PD fluid. Its use was evaluated in the settings of continuous ambulatory PD (CAPD) and continuous cycling PD (CCPD).

Methods

Total cells of one normal PD effluent were isolated, concentrated, and characterized by count, differential, Wright-Giemsa staining, and flow cytometry. PD effluent was spiked with known amounts of cells isolated from the PD effluent ranging from 5 to 90 leukocytes/µl. Solutions were analyzed in a cuvette (CAPD setup) or pumped through a drain line at 100 ml/min (CCPD setup). Turbidity was measured using the light sensor of a commercially available smartphone. An app (developed in-house) recorded illuminance in real time.

Results

PD effluent contained a total of 159 cells/µl of which 94.4% were red blood cells, 2.5 % leukocytes and 3.1% platelets. The differential showed 7.7% neutrophils, 71% lymphocytes, 18.7% monocytes, 0.8% eosinophils and 1.8% basophils. The PD effluent cell population was confirmed by Wright-Giemsa stain. Flow cytometry showed 20% peritoneal debris. Using the light sensor of the smartphone, a decrease in illuminance was detected with increasing cell concentration. At 90 leukocytes/µl, illuminance was decreased by 15% and 13% in CAPD and CCPD, respectively. The figure exemplifies the tight relationship between cell concentration in the PD effluent and illuminance in the CCPD setting.

Conclusion

A sensitive method to detect an increase of leukocytes in PD effluent was developed. This smartphone-based approach may aid in earlier detection of peritonitis in PD patients since even minor cloudiness can be measured.

Relationship between cell concentration in the PD effluent and illuminance.

Funding

  • Commercial Support