Urine lactic dehydrogenase--an aid in the management of patients with spinal cord injury.
Urine lactic dehydrogenase (LD) and urinary LD isoenzyme determinations were performed for 59 adult afebrile patients with spinal cord lesions. Twenty-eight were found to have a predominance of LD 1 and 2. Thirteen had positive urine cultures and 12 also had positive antibody coated bacteria (ACB). Twenty were found to have a predominance of LD 4 and 5, with a mean total urine LD activity of 175.7 mU/ml. Sixteen of this group had positive urine cultures and 12 also ACB positive. Eleven had no demonstrable LD isoenzyme with a mean total urine LD activity of 17.5 mU/ml. Eight had positive urine cultures and four were also ACB positive. Forty-six normal controls had a mean LD activity of 15.1 mU/ml. In the study population changes in U-LD occurred in the absence of bacteriuria most frequently in patients who were appliance-free or used catheterization. In the absence of bacteriuria bladder overdistention may contribute to changes in LD isoenzyme patterns.