Abstract: FR-PO0538
Clinical Assessment of Leukocyte Esterase Strips for Peritonitis Diagnosis in Patients on Peritoneal Dialysis
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Hussein, Rasha, Fresenius Medical Care, Clinical Research, New York, United States
- Wang, Xiaoling, Fresenius Medical Care, Clinical Research, New York, New York, United States
- Kotanko, Peter, Icahn School of Medicine at Mount Sinai, Department of Medicine, New York, New York, United States
Background
Peritonitis is a severe complication in peritoneal dialysis (PD), necessitating prompt diagnosis and therapy. Standard lab tests are slow, costly, and infrastructure-dependent, potentially delaying treatment. Leukocyte esterase strips (LES), as used for the diagnosis of urinary tract infections (UTI), offer a rapid, low-cost point-of-care alternative. This study assesses the effectiveness of LES for diagnosing PD-associated peritonitis.
Methods
Data from 56 pediatric PD patients and 277 2-hour dwell PD effluent samples were collected at Soba University Hospital, Khartoum, Sudan, from 2015 to 2020. LES tests (Multistix® 10 SG strips; Siemens) were done immediately after sample collection. LES were dipped into effluent, and the LES pad was read within 90–120 seconds. A result matching or darker than "MODERATE++" was considered positive. Lab white blood cell (WBC) counts were obtained within 2 hours for 109 samples. Day0 marked the initial LES test.
Results
Per international society of peritoneal dialysis (ISPD) guidelines, 20 of the 56 patients had peritonitis. All 20 peritonitis patients tested LES-positive on day0, with 440±320 WBC/µL, indicating 100% sensitivity. Follow-up samples (n=15) were collected on day3–5: six tested LES-negative (15-86 WBC/µL), and nine tested LES-positive (101-513 WBC/µL). WBC counts declined during follow-up (p=0.0003, paired t-test).
All 36 non-peritonitis patients tested LES-negative on day0 (51±24 WBC/µL), indicating 100% specificity. Over 7 days, all 206 additional samples from these patients remained LES-negative. Day0 WBC counts were significantly higher in the patients with peritonitis (p<0.0001; Figure 1).
Conclusion
UTI LES tests provide a rapid, inexpensive, and accurate screening tool for PD-associated peritonitis. Achieving 100% sensitivity and 100% specificity in this cohort, these results support timely diagnosis and treatment, particularly valuable in resource-limited and home-based care settings.