Introduction:
Ulinastatin, a urinary trypsin inhibitor, is an important intrinsic broad-spectrum protease inhibitor, believed to manage a series of pro inflammatory mediators and cytokines. Although no sufficient data, it reported to have protective effect on many organs in various infection states and sepsis and showed benefit in some of the studies.
Methods:
Retrospective observational study, when Ulinastatin combined with standard of care in the treatment of peritonitis along with APD in PD peritonitis patients.
Here we collected the data of patients who presented to us from Aug 2022 to Jul 2024, with symptoms of PD peritonitis, either on CAPD/ APD, shifted to cycler and started immediately with Standard of Care(SOC) including empirical antibiotics and additional Ulinastatin I.V 2,000,00 IU 12th hourly for 5 days in patients who have given consent for the same. Blood cultures, hs CRP, S. Procalcitonin, PD fluid cell count along with other imaging and lab parameters were considered as per the standard guidelines. Regular follow-up both clinically (APACHE II) and lab parameters were assessed and compared in a systematic way and analyzed.
Results:
A total of 28 peritonitis events seen during the study period. Among them 67.85% (n- 19) received Ulinastatin in addition to SOC for 5 days, whereas rest of the patients’ continued with standard treatment. 71.42% patient population being male with most common co-morbidity T2 DM followed by HTN was seen. Mean age of the study population was 36. 75 years. Following the treatment, patients in the Ulinastatin group showed better improvement in APACHE II scores (P < 0.01), better serum levels of procalcitonin, hsCRP levels and cell counts with statistically significant differences (P < 0.05) and decreased both ICU and in hospital stay when compared to standard treatment alone. There are similar safety profiles between both groups.
Conclusions:
Ulinastatin in combination with SOC for treating PD peritonitis exhibits a positive effect and can significantly improve the systemic inflammation and immune function in patients. This study suggests that Ulinastatin may be beneficial for PD peritonitis. Future studies are still needed to warrant the results of this study.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.