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

Abstract

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

• chronic kidney disease
• d-dimer
• diabetic nephropathy
• glomerulonephritis
• hypercoagulation