Association of D-dimers with acute kidney injury in pregnant women: a retrospective study

Abstract

Objective This study was performed to determine the association of D-dimers measured at the time of admission with the development of acute kidney injury (AKI) in pregnant women. Methods We retrospectively analyzed the data of 625 women who developed AKI and 628 normal pregnant women admitted to our hospital from January 2014 to December 2018. The primary endpoint of the study was the development of AKI in pregnant women, and the secondary endpoint was the development of dialysis and death in women with AKI. Univariate and multivariate analyses were conducted. Results The D-dimer concentration was significantly higher in patients with than without pregnancy-related AKI (PR-AKI). Multivariate logistic regression showed that a D-dimer concentration of >1108 ng/mL was an independent predictor of PR-AKI. The area under the curve of the D-dimer concentration as a prognostic indicator of PR-AKI was 0.652 (95% confidence interval, 0.622–0.683), that for patients with PR-AKI undergoing dialysis was 0.819 (95% confidence interval, 0.709–0.928), and that for patients who died was 0.828 (95% confidence interval, 0.670–0.986). Conclusion The D-dimer concentration is significantly associated with the development of AKI in pregnant patients and may increase the risk of dialysis and death in women with AKI.

Elevated preoperative D-dimer is associated with acute kidney injury after non-cardiac surgery

“…48 Even for pregnant women, elevated D-dimer is associated with AKI. 43 It can be seen that D-dimer's association with AKI is cross-crowd.…”

“…Studies have found that D-dimer is related to renal insu ciency. [41][42][43][44][45][46][47][48][49][50] Yang et al found that the D-dimer level could predict AKI and mortality in ST-elevated myocardial infarction patients. 41 Guerchicoff also reached a similar conclusion.…”

Association of D-dimer and acute kidney injury associated with rhabdomyolysis in patients with exertional heatstroke: an over 10-year intensive care survey

“…The laboratory diagnosis of ISTH about DIC includes platelets, D-dimer, fibrin degradation products, FIB, and PT [ 13 ]. It has also been reported that D-dimer as a coagulation-related marker could be used as an effective factor for predicting the occurrence of AKI [ 8 , 9 , 22 ]. In recent years, it was suggested that the D-dimer concentration is likely to rise in the setting of systemic inflammation and infection [ 23 , 24 ].…”

Disseminated intravascular coagulation associated organ failure in obstetric patients admitted to intensive care units: a multicenter study in China

“…Studies on the relationship between ARF and DIC in obstetrics are rare and are nearly all case series 19 , 21 – 27 . Although Stratta et al 21 , 24 , 28 found that DIC does not have a significant relationship with the severity of renal failure in patients recovering from kidney conditions and although DIC is not directly related to the morphological changes in the kidney 29 , DIC is associated with maternal mortality 30 ; the d -dimer concentration can be used as an independent predictor of PR-AKI 31 , potentially indicating that DIC triggers ARF by provoking the release of cytokines from the endothelium 32 or interacting with the complementary systems 33 , 34 , which are important mechanisms of kidney injury 35 – 37 , but not by thrombosis in the kidney.…”