Diagnostic Significance of Lactate Dehydrogenase in Spontaneous Bacterial Peritonitis in Patients with Cirrhosis of Liver with Ascites

Background: The term ascites refers to the presence of excessive pathological fluid in peritoneal cavity. The term spontaneous bacterial peritonitis (SBP) is defined as the infection of ascitic fluid without any evidence of intra-abdominal, surgically treatable cause of infection. The importance of early detection of SBP is must as it develops in about 10%–30% patients and has high mortality rates. Aims and Objectives: To study diagnostic significance of ascitic fluid Lactate Dehydrogenase (LDH) levels in evaluation of SBP in patients with liver cirrhosis and to find a correlation between ascitic fluid LDH and serum LDH in SBP and non-SBP cirrhotic patients. Materials and Methods: This is a cross-sectional observational study done at the Department of Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar, where 152 subjects were taken and were divided into SBP ( n = 45) and non-SBP group ( n = 107). Ascitic fluid analysis (diagnostic paracentesis) was done, and samples were sent for cytology, biochemistry and culture sensitivity. Results: It was observed that ascitic fluid LDH in patients with SBP had median (IQR) value of 308 U/L (233–641) as compared to 102 U/L (83–124) in non-SBP group ( P < .01). The median (IQR) of ascitic fluid LDH to Serum LDH was 1.2 (0.74–1.96) in the SBP group as compared to 0.35 (0.27–0.46) in the non-SBP group ( P < .01). Conclusion: The results of our study suggest that ascitic fluid LDH and ascitic fluid LDH to serum LDH ratio can be used as a diagnostic marker for SBP in patients with cirrhosis of liver.