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Does pyuria indicate infection in asymptomatic dialysis patients?
R P Eisinger1, F Asghar, C Kolasa
1UMDNJ-Robert Wood Johnson Medical School, Department of Medicine, New Brunswick 08903, USA.
Clinical Nephrology
|January 1, 1997
Summary
Leukocyturia, or white blood cells in urine, does not reliably indicate urinary tract infections in asymptomatic dialysis patients. This finding suggests it is not a useful marker for diagnosing infections in this population.
Area of Science:
- Nephrology
- Clinical Pathology
Background:
- Asymptomatic leukocyturia (white blood cells in urine) is often suggested as a predictor of positive urine cultures and urinary tract infections (UTIs) in dialysis patients.
- End-stage renal disease (ESRD) patients on dialysis may present unique challenges in interpreting urine analysis findings.
Purpose of the Study:
- To evaluate the diagnostic utility of leukocyturia (> 10 WBC/HPF) as a marker for positive urine cultures and UTIs in asymptomatic ESRD patients undergoing dialysis.
Main Methods:
- Clean catch urine specimens were collected from seventeen asymptomatic ESRD patients on dialysis.
- Urine samples were analyzed for the presence of white blood cells (WBCs) per high-power field (HPF) and cultured for microbial pathogens.
Main Results:
- Nine out of seventeen patients (53%) exhibited leukocyturia (> 10 WBC/HPF).
- Only one of these nine patients (11% of total patients, 23% of those with leukocyturia excluding multiple organism cultures) had a positive urine culture for a possible pathogen.
- The presence of leukocyturia did not consistently correlate with positive urine cultures.
Conclusions:
- Leukocyturia is not a reliable indicator of positive urine cultures in asymptomatic dialysis patients.
- The finding of leukocyturia alone is insufficient to diagnose a urinary tract infection in this specific patient group.