Ukr.Biochem.J. 2020; Volume 92, Issue 3, May-Jun, pp. 71-76

doi: https://doi.org/10.15407/ubj92.03.071

D-dimer as a potential predictor of thromboembolic and cardiovascular complications in patients with chronic kidney disease

04.08.2020   Uncategorized   No comments

I. S. Mykhaloiko1*, I. O. Dudar2, I. Ja. Mykhaloiko1, O. Ja. Mykhaloiko1

1SHEE “Ivano-Frankivsk National Medical University”, Ivano-Frankivsk, Ukraine;
2SI “Institute of Nephrology AMS of Ukraine”, Kiev, Ukraine;
*e-mail: iralisn@gmail.com

Received: 13 February 2020; Accepted: 30 June 2020

The aim of the study was to evaluate the relationship between D-dimer levels and different biomarkers­ of renal diseases to identify the relationship between hypercoagulation and chronic kidney disease (CKD). To achieve this aim, we conducted a one-step prospective observational study involving 140 patients with CKD who were hospitali­zed in Ivano-Frankivsk Regional Clinical Hospital in Ukraine during 2018-2019. Of these patients, 100 patients (71.4%; 95% CI 53.4-76.7) had glomerulonephritis (GN) and 40 patients (28,6%; 95% CI 21.3-36.8) had diabetic nephropathy (DN). All patients underwent standard examination, which included general clinical, biochemical and instrumental research methods. D-dimer was quantitatively determined in blood serum by enzyme-linked immunosorbent assay (ELISA). The 140 patients were divided into two groups according to the level of D-dimers: normal level (<0.5 mg/l) and elevated level (≥0.5 mg/l). Elevated D-dimer levels were associated with an increased age of patients, decreased glomerular filtration rate, decreased blood albumin level, increased daily protein excretion and a tendency to develop thromboembolic complications during 1 year of monitoring. D-dimer is a biological marker that can detect hypercoagulation at an early preclinical stage in patients with CKD and identify patients with an increased cardiovascular risk, thereby promoting the earliest use of antiplatelet agents and anticoagulants  and, consequently, it can reduce mortality­.

Keywords: , , , ,

References:

  1. Kolesnyk  M.  Innovative  directions  of  CKD  prevention  and  treatment.  Ukr J Nephr Dial. 2019; 1(61): 3-12.
  2. Christiansen CF, Schmidt M, Lamberg AL, Horváth-Puhó E, Baron JA, B Jespersen B, Sørensen HT. Kidney disease and risk of venous thromboembolism: a nationwide population-based case-control study. J Thromb Haemost. 2014;12(9):1449-1454. PubMed, CrossRef
  3. Pavord S, Myers B. Bleeding and thrombotic complications of kidney disease. Blood Rev. 2011;25(6):271-278. PubMed, CrossRef
  4. Folsom AR, Lutsey PL, Astor BC, Wattanakit K, Heckbert SR, Cushman M, Atherosclerosis Risk in Communities Study. Chronic kidney disease and venous thromboembolism: a prospective study. Nephrol Dial Transplant. 2010;25(10):3296-301. PubMed, PubMedCentral, CrossRef
  5. Tan X, Chen G, Liu Y, Zhou L, He L, Liu D, Liu Ye, Zhang F, Li H, Liu H. Serum D-dimer is a potential predictor for thromboembolism complications in patients with renal biopsy. Sci Rep. 2017;7(1):4836. PubMed, PubMedCentral, CrossRef
  6. Pulivarthi S, Gurram MK. Effectiveness of d-dimer as a screening test for venous thromboembolism: an update. N Am J Med Sci. 2014;6(10):491-499.
    PubMed, PubMedCentral, CrossRef
  7. Sextona DJ, Clarksona MR, Mazura MJ, Planta WD, Eustacea JA. Serum D-dimer concentrations in nephrotic syndrome track with albuminuria, not estimated glomerular filtration rate. Am J Nephrol. 2012;36(6):554-60. PubMed, CrossRef
  8. Mohammed NMS, Khalil HBE. D-dimer levels in patients presenting chronic kidney disease in Sudan. Am J Med Med Sci. 2016; 6(3): 120-122. CrossRef
  9.  Wakabayashi I, Masuda H. Association of D-dimer with microalbuminuria in patients with type 2 diabetes mellitus. J Thromb Thrombolysis. 2009;27(1):29-35. PubMed, CrossRef
  10. Domingueti CP, Fóscolo RB, Dusse LMS,  Reis JS, das Graças Carvalho M, Gomes KB, Fernandes AP. Association of different biomarkers of renal function with D-dimer levels in patients with type 1 diabetes mellitus (renal biomarkers and D-dimer in diabetes. Arch Endocrinol Metab. 2018;62(1):27-33. PubMed, CrossRef
  11. Shibata T, Magari Y, Mizunaga S, Okabe E, Sumie A, Ishii T, Tomo T, Yasumori R, Nasu M. Significance of urinary fibrin/fibrinogen degradation product (FDP) D-dimer measured by highly sensitive ELISA method with a new monoclonal antibody (D-D E72) in various renal diseases.  Nihon Jinzo Gakkai Shi. 1994; 36(7): 805-812. (In Japanese). PubMed
  12. Kato S, Chernyavsky S, Tokita JE, Shimada YJ, Homel P, Rosen H, Winchester J. Relationship between proteinuria and venous thromboembolism. J Thromb Thrombolysis. 2010;30(3):281-285. PubMed, CrossRef
  13. Jenkins PV, O’Donnell JS. ABO blood group determines plasma von Willebrand factor levels: a biologic function after all? Transfusion. 2006; 46(10): 1836-1844.  PubMed, CrossRef
  14. Haase C, Joergensen M, Ellervik C, Joergensen MK, Bathum L. Age- and sex-dependent reference intervals for D-dimer: evidence for a marked increase by age. Thromb Res. 2013;132(6):676-680. PubMed, CrossRef
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