Usefulness Of Dialysate Fibrin Degradation Products And Lactic-Dehydrogenase Isoenzyme Patterns In Assessing The Clinical Course Of Peritonitis

Objective: To establish the usefulness of fibrin degradation products (FDP) and lactic dehydrogenase isoenzyme patterns (LDH isoenzyme) in assessing the clinical course of peritonitis.Design: A retrospective study of patients with peritonitis who were divided into three groups according to their clinical course.Setting: Single dialysis unit of a general hospital.Interventions: Patients were treated by intraperitoneal and oral antibiotics.Patients:Twenty-six patients with 34 episodes of peritonitis were studied. Group 1 consisted of 21 patients with 26 recoveries from peritonitis; Group 2 consisted of 5 patients with 5 relapsing episodes of peritonitis, and Group 3 consisted of 3 patients with 3 persistent episodes of peritonitis.Main Outcome Measures: Concentrations of WBCs, FDP, LDH isoenzyme and microbiological culture of the dialysate were determined.Results: In most of Group 1, WBCs, FDP, and LDH isoenzyme returned to normal within 2 weeks. In 4 patients of Group 1, who had complications (diverticulitis, cholecystitis, cystitis, and tunnel infection), WBCs, FDP, and LDH isoenzyme returned to normal gradually within 3 weeks. In Group 2, WBCs returned to normal, but FDP remained relatively high and LDH isoenzyme did not normalize. In Group 3, WBCs, FDP and LDH isoenzyme did not normalize.Conclusions: Failure of normalization of FDP and LDH isoenzyme suggests an incomplete recovery from peritonitis. FDP and LDH isoenzyme are useful in assessing the course of peritonitis.