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Study of Urinary Lactic Dehydrogenase and Isoenzyme Patterns in Patients with Urinary Tract Infection.

Journal of the Korean Pediatric Society 1983;26(5):463-469.
Published online May 31, 1983.
Study of Urinary Lactic Dehydrogenase and Isoenzyme Patterns in Patients with Urinary Tract Infection.
Eui Soo Park, Jeh Hoon Shin, Woo Gill Lee
Department of Pediatrics, Hanyang University College of Medicine, Seoul,Korea
요로감염증 환아의 소변내 Lactic dehydrogenase 활성도 및 Isoenzyme 분획상에 관한 연 구
박 의 수, 신 재 훈, 이 우 길
한양대학교 의과대학 소아과학교실
Abstract
The site of the infection is an important factor in the evaluation of the course and prognosis of patients with urinary tract infection (UTI) since patients with bacteriuria of renal origin are probably at risk of developing the renal parenchymal reduction seen in some of these patients. So direct and indirect methods have been developed to accomplish precise location of the site of UTI. Direct methods include culture of kidney biopsy tissue or of ureteral urine and the bladder washout test, and indirect methods include assessment of maximal urine concentrating capacity, determination of specific serum antibodies to the infilterating organism, CRP and ESR. And urinary enzyme assay such as lysozyme, yS-glucuronidase and lactic dehydrogenase (LDH). The present investigation showed that LDH isoenzyme patterns were valuable to differentiate between pyelonephritis and cystitis. And we measured urinary LDH and its isoenzyme patterns in 26(12 males and 14 females) .patients with UTI to differentiate between upper UTI (pyelonephritis) and lower UTI (cystitis), which revealed urine culture positive (colony counts: more than 100,000/ml), and .following results and obtained. 1) Total urinary LDH in UTI group was from 0 to 581,400 units/24 hrs, and its mean value was 97,636.5±124,215.2 units/24 hrs. And total urinary LDH in renal disease group of non-UTI group was 1,800 to 162,000 units/24 hrs, its mean value was 80,958.8±54,137.9units/24 hrs, and total urinary LDH in non-renal disease group of non-UTI group was 0 to 40,000 units/24hrs, its mean value was 24,550.0±14,478.6 units/24 hrs. These difference between UTI group and non-renal disease group of non-UTI group was .statistically significant (p<0.01). 2) On urinary LDH isoenzyme electrophoresis, suspected pyelonephritis group showed as follows: type 1; 24.5±9.6% type 2; 23.9+4.7%, type 3; 16.4±5.4%, type 4; 14.8±9.4%, type 5; 19.2±9.3%, and suspected cystitis group showed as follows: type 1; 40.2±8.8%, type 2; 29.1±7.4%, type 3; 13.6±7.9%, type 4; 14.8±9.4%, type 5; 6.1±3.1%. Therefore we learned that suspected pyelonephritis group had higher concentrations than Teference value in type 4 and type 5, and suspected cystitis group had higher concentrations than reference value in type 1. 3) CRP positive rate was 70% in suspected pyelonephritis group, wheras 31.3% in suspected cystitis. 4) No significant difference between suspcted pyelonephritis group and suspected cystitis group was noted in ESR and WBC count. Thereforewe learned that urinary LDH isoenzyme patterns and CRP are greatly valuable differentiate between pyelonephritis and cystitis.
Key Words: CRP, cystitis, ESR, lactic dehydrogenase lactic dehydrogenase isoenzyme, pyelonephr-aitis, urinary tract infection, WBC counts.


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