Normal individuals do not typically have detectable levels of FDP (Fibrin Degradation Products) in their urine, with the indirect coagulation inhibition test showing values below 0.25 μ g/ml. However, an elevated presence of urinary FDP holds great significance.
(2) The presence of glomerular inflammation and local hypercoagulability in the kidney warrants further investigations to rule out other coagulation disorders like disseminated intravascular coagulation, pulmonary infarction, leukemia, deep venous thrombosis among others. It's imperative to differentiate the underlying cause of these symptoms to administer the appropriate treatment.
Glomerulopathy can be classified based on the continuous determination of urinary FDP. Chronic nephritis showed positive results in 67% to 81% of cases, with a concentration greater than 1.25 μg/ml. Decreased or negative FDP levels during treatment indicate improvement in the condition. On the other hand, if FDP levels are less than 1.25 μg/ml, there is a high possibility of primary glomerulonephritis, also known as minimal lesion type. Increased and unchanged FDP levels indicate proliferative, membranous proliferative, or rapidly progressive crescent type of glomerulopathy. Among them, crescent nephritis had the highest FDP levels.
The amount of fibrin deposition, as detected in renal biopsy specimens, showed a strong correlation with the increase of FDP. Therefore, healthcare professionals can utilize the measurement of FDP as a reliable indicator for determining the effectiveness of anticoagulant therapy, including the administration of heparin, in clinical practice.
The efficacy of glucocorticoid treatment varies depending on the levels of urinary FDP. In cases of nephrotic syndrome where urinary FDP is negative, glucocorticoid treatment proves to be effective. Patients with urinary FDP levels below 2.5 μg/ml tend to have better treatment outcomes compared to those with urinary FDP levels exceeding 2.5 μg/ml. Furthermore, it is observed that the higher the concentration of urinary FDP, the poorer the response to hormone therapy.
The severity of the disease is reflected in the concentration of urinary FDP. If the concentration of urinary FDP remains high or continues to increase, it indicates that the inflammatory lesion in the renal parenchyma is either serious or active, with poor prognosis. Conversely, a low concentration of urinary FDP suggests a good prognosis, such as in cases of occult nephritis. Therefore, the monitoring of urinary FDP concentration can provide valuable information about the state of the disease and its likely trajectory.
To determine the efficacy of renal transplantation, one can assess the level of FDP in the urine. This serves as an indicator of success or failure, with a rapid increase in FDP levels being a sign of acute rejection. Therefore, monitoring FDP levels is crucial in evaluating the outcome of the transplantation procedure.
