What does fibrin look like compared to protein. I was always taught fibrin looks like cooked egg whites and protein looks mucousy or like a little jelly fish.

Questions About PD

Karen Dalton, from Wyomissing, PA. asked
What does fibrin look like compared to protein. I was always taught fibrin looks like cooked egg whites and protein looks mucousy or like a little jelly fish.

1 answer

Nurse Canada with members of the ISPD Nursing Committee August 2, 2022

We thank you for your interesting question. Fibrin is actually a naturally occurring protein. It is not uncommon for patients on peritoneal dialysis to form fibrin that intermittently passes in their PD effluent, especially in the presence of peritonitis. However, it is important that the home PD patient is taught how to recognize fibrin, since its formation can lead to blockage of the PD catheter. While it is common for home PD nurses to use the description of this fibrin to their patients as appearing like strands of “cooked egg white” in the PD effluent, it has also been described by nephrology practitioners in articles, blogs and procedures as looking like “small jelly fish”, “mini spaghetti”, “white or yellowish cotton wool” “white threads” or “floating cobwebs” (1, 2). All descriptors are to aid in helping patients on PD recognize fibrin in their PD effluent.
 
One most important point is for home PD nurses to be able to help their patients distinguish in PD effluent between fibrin formation in the absence of peritonitis and fibrin formation in the presence of peritonitis. If there is any doubt, the home PD nurse should help the patient organize to have a sample of PD effluent sent to the laboratory for white blood cell (WBC) count, Gram stain and culture to exclude infection (3).
 
1. John Agar. Home Dialysis Central.  Use of heparin on PD. 2019. Accessed on August 2, 2022. Available at: https://forums.homedialysis.org/t/use-of-heparin-on-pd/7130
 
2. British Columbia (BC) Renal Agency. Glossary of frequently used terms. May 2020. Available at: http://www.bcrenal.ca/resource-gallery/Documents/RR_PD-Glossary%20of%20Frequently%20Used%20PD%20Terminology.pdf
 
3. Davies SJ, Wilkie ME. Complications of Peritoneal Dialysis. In: Johnson RJ, Feehally J, Floege J, Tonelli M, editors.  Comprehensive Clinical Nephrology. 6th ed. Philadelphia PA: Elsevier/Saunders: 2019. P. 1114.

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