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 a ssessing the clinical course of peritonitis. Design: A retrospective s tudy of patients with peritonitis who were divided into three groups a ccording to their clinical course. Setting: Single dialysis unit of a general hospital. Interventions: Patients were treated by intraperiton eal and oral antibiotics. Patients:Twenty-six patients with 34 episode s of peritonitis were studied. Group 1 consisted of 21 patients with 2 6 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: Con centrations 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 o f Group 1, who had complications (diverticulitis, cholecystitis, cysti tis, and tunnel infection), WBCs, FDP, and LDH isoenzyme returned to n ormal gradually within 3 weeks. In Group 2, WBCs returned to normal, b ut FDP remained relatively high and LDH isoenzyme did not normalize. I n Group 3, WBCs, FDP and LDH isoenzyme did not normalize. Conclusions: Failure of normalization of FDP and LDH isoenzyme suggests an incompl ete recovery from peritonitis. FDP and LDH isoenzyme are useful in ass essing the course of peritonitis.