The Value Of Neutrophil Gelatinase Associated Lipocalin In Diagnosis Of Peritoneal Dialysis Related Peritonitis

Objective To discuss the value of NGAL in peritoneal dialysis related peritonitis patients who has peritoneal fluid.Methods we collected 60 patients who had a definite diagnosis with peritoneal dialysis related peritonitis during 2013 to 2016 in our hospital and divided them into three groups according to different culture results of peritoneal fluid: culture negative group(n = 20),gram positive bacteria group(n = 24),and gram negative bacteria group(n = 16).Also,we choose stable peritoneal dialysis patients(n=30)as control group.In addition,general clinical data,blood sample and peritoneal dialysis fluid specimens in the derivation of all patients were collected.Enzyme Linked Immunosorbent Assay was used to test the level of NGAL in the first bag of peritoneal fluid once they admitted to hospital.At the same time,peritoneal fluid is delivered to clinical laboratory for bacterial culturing.The concentration of IL – 6,white blood cell count,percentage of multiple nuclear cell,whole blood of white blood cell count and c-reactive protein in fluid derivation of peritoneal dialysis were determined either.Results 1.compared with control group,the level of NGAL,IL-6,WBC count and the percentage of multiple nuclear cell in peritonitis group was obviously increased(p<0.05).The levels of leukocyte,the percentage of neutrophil and C-reactive protein in blood of peritonitis patients were significantly higher than those of control group.The difference was statistically significant(p<0.05).The levels of serum creatinine,serum albumin,transferrin and transferrin saturation decreased significantly (p<0.05).objects of age,hemoglobin,parathyroid hormone and ferritin have no differences between two groups(p>0.05);2.Compared with control group,the levels of NGAL,IL-6,WBC count and the percentage of multiple nuclear cell in peritoneal fluid were significantly higher in G+ group,G-group and culture negative group(p<0.05);3.Comparison among G+ group,G-group and culture negative group,NGAL and the percentage of multiple nuclear cell in G+ group and G-group were significantly higher than those in culture negative group.However,above indicators between G+ group and G-group have no significant differences(p>0.05).4.NGAL in peritoneal fluid was positively correlated with WBC count in peritoneal fluid(r=0.492,and p<0.05),while the parameter of IL-6 in peritoneal fluid has no correlation with WBC count in peritoneal fluid(r=0.034,p>0.05);5.To explore the predictive value of NGAL,IL-6,WBC count for the occurrence of peritoneal dialysis related peritonitis and the results of peritoneal fluid culture,we implemented equation fitting by using Binary classification logistic regression analysis and get the results that peritoneal fluid NGAL significantly associated with peritonitis(OR=1.028,p<0.05)and positive culture(OR=0.998,p<0.05).Above indicators in G+ group and G-group are with no significant differences yet(p>0.05).Conclusion NGAL in peritoneal fluid could be used as a reliable index for predicting the occurrence of peritoneal dialysis related peritonitis and distinguish bacterial positive and negative culturing.