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Presentation Details
| Evaluation of D-Dimer in Patients with End-Stage Renal Disease Sana Verma1, Keerti CHAKRAVARTHY1, Fakiha Siddiqui2, Vinod Bansal2, Jawed Fareed2. 1Global Thrombosis Forum, Suwanee, GA, USA.2Loyola University, Chicago, IL, USA |
Abstract
Background End-stage renal disease (ESRD) is the final stage of chronic kidney disease, characterized by severely reduced renal function and the inability to adequately excrete metabolic waste products, including creatinine, and excess fluid. Normal glomerular filtration rate ranges from 90-120 mL/min/1.73 m²; whereas in ESRD patients, it falls below 15 mL/min/1.73 m². Healthy patients tend to have a glomerular filtration rate of 90 to 120 mL/min/1.73 m²; in patients with ESRD, it falls below 15 mL/min/1.73 m². ESRD also affects the body’s hemostatic balance. Waste product buildup in the blood and endothelial dysfunction can disrupt normal coagulation and fibrinolysis, leading to increased fibrinolytic activity. This increase can result in elevated levels of fibrinolytic deficit markers, such as D-dimer, a biomarker of ongoing fibrin turnover and fibrinolytic activity in ESRD patients. Objectives Our objective was to compare D-dimer levels between healthy individuals and ESRD patients to understand the correlation between ESRD and D-dimer levels. Methods A cohort study was conducted with two groups: a control group of healthy individuals (n=50) with no history of kidney disease and ESRD patients (n=72). To measure D-dimer levels, blood samples were collected from both groups and analyzed using commercially available sandwich ELISA methods. The comparison between the two groups was performed using a Mann-Whitney test due to the non-normal distribution of the data, with a p-value of <0.0001. Results (Figure 1) Compared to healthy individuals (median(25%-75%): (0.000(0.000-52.55))), patients with ESRD (953.8(386.9-2465)) showed higher D-dimer levels (p <0.0001), indicating a direct correlation between elevated D-dimer levels and ESRD patients. The standard deviation and mean values from both groups also suggest this correlation, with the high standard deviation in the ESRD group indicating that D-dimer levels are much more variable, and the high mean value suggesting that levels are much higher in this group. Conclusion The findings of this study suggest that patients with ESRD exhibit significantly higher D-dimer levels compared to healthy individuals, indicating increased fibrinolytic activity and endothelial dysfunction. These results support the use of D-dimer as a potential biomarker of fibrinolytic deficit for assessing coagulation and fibrinolytic activity in patients with advanced kidney disease. Further research with larger sample sizes and longitudinal data is warranted to explore the prognostic value of D-dimer in predicting disease progression and related complications in ESRD patients.
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No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.