Modern view in diagnosis of uremic pseudoperitonitis and peritonitis in patients on renal replacement therapy (programmed hemodialysis)

Abstract

Objective. Determination of blood serum β₂-microglobulin and lactoferrin concentration in patients on renal replacement therapy (programmed hemodialysis) for the diagnosis of uremic pseudoperitonitis and peritonitis.

Materials and methods. We examined 56 patients admitted to the Surgical Department of Astrakhan Clinical Hospital “RZhD-Medicine” and City Clinical Hospital № 3, and studied the concentration of blood serum β₂-microglobulin and lactoferrin in patients urgently hospitalized with suspicion of uremic pseudoperitonitis or peritonitis, who receive renal replacement therapy (programmed hemodialysis). The control group included 50 outpatients on renal replacement therapy (programmed hemodialysis). The study did not include patients with suspected peritonitis who did not receive renal replacement therapy (programmed hemodialysis). The period of the study is 2019–2021.

Results. The concentration of serum β₂-microglobulin is statistically higher than normal in all patients receiving renal replacement therapy (programmed hemodialysis) in anamnesis. The most statistically high concentration of β₂-microglobulin was detected in patients with uremic pseudoperitonitis (n = 39), and was 30000 ± 6680 ng/ml compared with the concentration in the blood serum among patients with peritonitis 6000 ± 519.9 ng/ml. The concentration of lactoferrin is statistically high in peritonitis (n = 17) and was 3480 ± 439 ng/ml compared with uremic pseudoperitonitis 1160 ± 148 ng/ml. In the control group of outpatients (n = 50), who received renal replacement therapy (programmed hemodialysis), no statistically significant concentrations of blood serum β₂-microglobulin and lactoferrin were detected.

Conclusions. A clear dependence of β₂-microglobulin and lactoferrin concentrations on the severity of uremic pseudoperitonitis and peritonitis was established. Statistically high values of β₂-microglobulin concentration were obtained in patients with uremic pseudoperitonitis, and the level of lactoferrin was statistically high in peritonitis.

Keywords

uremic pseudoperitonitis / peritonitis / renal replacement therapy / programmed hemodialysis / β2-microglobulin / lactoferrin

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