Clinical Investigation on Localization of Urinary Tract Infection by Total Urinary LDH Activity and Isoenzyme Pattern

Choi, Kyung Jin; Lee, Hee Yong

Abstract

Precise location of the site of infection is the most important step to determine the proper management of patients with urinary tract infection. Since lower tract infection, i. e., cystitis, is associated with almost no long-term morbidity or mortality, treatment does not need to be intensive or prolonged. Conversely, upper tract infection, or pyelonephritis, is a serious clinical problem with a definite risk of immediate and long-term complications. Accordingly, most urologist want to find a reliable, noninvasive technique to localize the site of urinary tract infection. We herein made clinical study of level of total urinary LDH activity and its isoenzyme pattern to localize the site of infection on 13 renal infection patients (6 males and 7 females). 12 bladder infection patients (5 males and 7 females), and 11 normal control group (9 males and 2 females). The results obtained in this clinical study the as follows; 1. Normal control group; Range of total urinary LDH activity was 0-12 IU/1 and mean value was 3.8 IU/1. Urinary LDH isoenzyme 1 and 2 (fast zone) predominated. (84.1% of total urinary LDH activity) 2. Renal infection group; Range of total urinary LDH activity was 20-85 IU/1 and mean value was 45.1 IU/1. Urinary LDH isoenzyme 4 and 5(slow zone) highly increased in 10 cases (77%). 3. Bladder infection group; Range of total urinary LDH activity was 8-75 IU/1 and mean value was 31.5 IU/1. Total urinary LDH activity in bladder infection patients was higher than in normal control group but lower than in renal infection patients. In two bladder carcinoma patients with bladder infection, urinary LDH isoenzyme 5 highly increased. 4. In urinary tract infection, total urinary LDH activity highly increased. Level of total urinary LDH activity in renal infection was higher than in bladder infection and its isoenzyme patterns revealed slow zone predominance. In patients with bladder infection, the isoenzyme patterns varied but fast zone slightly increased than slow zone. Localization of urinary tract infection by total urinary LDH activity and its isoenzyme patterns the most reliable, noninvasive, quickly available and easy to perform technique.