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Abstract: FR-OR78

QuickCheck: A Point-of-Care Method for Rapid Cell Counting in Peritoneal Dialysis-Associated Peritonitis

Session Information

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Qazi, Junaid Z., Manchester Royal Infirmary, Manchester, United Kingdom
  • Baharani, Jyoti B., Birmingham Heartlands Hospital, Birmingham, West Midlands, United Kingdom
  • Kununa, Amna, Tallaght University Hospital, Dublin, Dublin, Ireland
  • O'Keeffe, Hannah Marie, Tallaght University Hospital, Dublin, Dublin, Ireland
  • John, Annamma, Tallaght University Hospital, Dublin, Dublin, Ireland
  • Young, Jen, Tallaght University Hospital, Dublin, Dublin, Ireland
  • Seery, Conor Oliver, Tallaght University Hospital, Dublin, Dublin, Ireland
  • Gannon, Helen Maria, Tallaght University Hospital, Dublin, Dublin, Ireland
  • Vardhan, Anand, Manchester Royal Infirmary, Manchester, United Kingdom
  • Chevarria, Julio L., Tallaght University Hospital, Dublin, Dublin, Ireland
Background

Peritoneal dialysis (PD) associated peritonitis is a severe complication, often requiring hospitalization and transfer to hemodialysis. Diagnostic criteria include clinical features, effluent white cell count, and culture. The standard method of cell counting is manual microscopy, which is expensive and time-consuming. QuickCheck is CE marked, point-of-care device that utilizes laser light to instantly determine the cell count. We assess the comparability in detecting the number of cells in PD effluent samples and evaluate accuracy and precision in diagnosis of peritonitis.

Methods

A non-interventional study for method comparison was conducted in PD unit of Tallaght University Hospital, Manchester Royal Infirmary, and Birmingham Heartlands Hospital. From June 2022 to April 2023, effluent samples from patients with suspected peritonitis were analyzed with QuickCheck and manual microscopy. We included patients >18 y old, on PD, suspected peritonitis, and PD effluent culture. Reproducibility was assessed using intra-class correlation coefficients (ICC), validity by sensitivity, specificity, predictive values, and likelihood ratios. Bland-Altman graphs estimate bias and limits of agreement.

Results

89 patients were included. The median cell count was 48 (IQR 18-662) for manual microscopy and 86 (IQR 18.5-595) for QuickCheck. The ICC agreement was 0.93 (95%CI 0.89-0.95), and consistency 0.93 (CI95% 0.89-0.95). Blant-Altman graphic is detailed. Sensitivity was 71% and 75%, specificity 78% and 69%, PPV 83% and 78%, NPV 65% and 66%, LR+ 3.2 and 2.47, LR- 0.36 and 0.35, accuracy 74% (CI95% 64-83) and 73% (CI95% 63-82) for QuickCheck and manual microscopy, respectively.

Conclusion

QuickCheck is comparable to manual microscopy in accuracy and reproducibility in cell counting. The high specificity with a cell count >100 cells suggests that QuickCheck is a reliable point-of-care method for rapid diagnosis and treatment of PD-associated peritonitis. Its speed, simplicity, and portability make it an attractive option for use at the point-of-care.