PMID- 27891369
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2249-782X (Print)
IS  - 0973-709X (Electronic)
IS  - 0973-709X (Linking)
VI  - 10
IP  - 10
DP  - 2016 Oct
TI  - The Diagnostic Value of Urinalysis in Hemodialysis Patients with Fever, Sepsis or 
      Suspected Urinary Tract Infection.
PG  - OC11-OC13
AB  - INTRODUCTION: The diagnostic validity of urinalysis in asymptomatic Hemodialysis 
      (HD) patients is low and there is limited data on the diagnostic value of 
      urinalysis in HD patients with fever, sepsis, or suspected Urinary Tract 
      Infection (UTI). AIM: The aim of this study was to assess the sensitivity, 
      specificity, positive and negative predictive value of pyuria, bacteriuria, 
      Leukocyte Esterase (LE) and nitrite positivity in symptomatic, febrile or/and 
      septic HD patients. MATERIALS AND METHODS: A single-center, retrospective study 
      was performed at New York University Lutheran Medical Center, Brooklyn, New York 
      City, USA, in order to investigate the diagnostic validity of pyuria, 
      bacteriuria, LE and nitrite positivity in HD patients with admitting diagnosis of 
      fever, sepsis or UTI from September 2008 to August 2015. RESULTS: A total of 275 
      HD patients were included in the study. There was significant association between 
      pyuria of different cut-offs (>5,>10,>50 WBC/HPF) and urine culture positivity 
      (p<0.001) and growth of >/=100,000 CFU/mL (p=0.039), but there was no association 
      with fever or sepsis. The sensitivity and specificity of pyuria >10 WBC/HPF for 
      positive urine culture with >100,000 CFU/mL was 86% and 35% respectively 
      (p=0.025). Pyuria >50 WBC/HPF showed a sensitivity of 66% and a specificity of 
      58% (p=0.032). There was also association between bacteriuria, LE positivity and 
      positive urine cultures but not with >/=100,000 CFU/mL. CONCLUSION: Our study 
      results suggest that urinalysis is not a reliable diagnostic tool in febrile 
      and/or septic HD patients and a urine culture is needed. In such patients, 
      physicians should also maintain a high level of clinical suspicion for other 
      potential sources of infection, which may not be initially evident.
FAU - Oikonomou, Katerina G
AU  - Oikonomou KG
AD  - Physician, Department of Medicine, New York University Lutheran Medical Center , 
      Brooklyn, New York, USA .
FAU - Alhaddad, Adib
AU  - Alhaddad A
AD  - Adjunct Instructor, Department of Medicine, New York University Lutheran Medical 
      Center , Brooklyn, New York, USA .
LA  - eng
PT  - Journal Article
DEP - 20161001
PL  - India
TA  - J Clin Diagn Res
JT  - Journal of clinical and diagnostic research : JCDR
JID - 101488993
PMC - PMC5121707
OTO - NOTNLM
OT  - End stage renal disease
OT  - Morbidity
OT  - Symptoms
EDAT- 2016/11/29 06:00
MHDA- 2016/11/29 06:01
PMCR- 2016/12/01
CRDT- 2016/11/29 06:00
PHST- 2016/06/11 00:00 [received]
PHST- 2016/08/10 00:00 [accepted]
PHST- 2016/11/29 06:00 [entrez]
PHST- 2016/11/29 06:00 [pubmed]
PHST- 2016/11/29 06:01 [medline]
PHST- 2016/12/01 00:00 [pmc-release]
AID - 10.7860/JCDR/2016/21992.8617 [doi]
PST - ppublish
SO  - J Clin Diagn Res. 2016 Oct;10(10):OC11-OC13. doi: 10.7860/JCDR/2016/21992.8617. 
      Epub 2016 Oct 1.