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D-dimer Levels in Chronic Kidney Illness: A Comprehensive and Systematic Literature Review

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Enduring kidney illness (CKD) is a mounting worldwide issue with respect to people’s health, needing to get handled in its primary phases by internal specialists. Cardiovascular threats related to all phases of CKD are the main worry. One can measure D-dimer (D-D) generated in the period of the failure of cross-linked fibrin by enzyme immunoassay with the use of monoclonal antibodies. Despite the vital importance of diagnosing and treating this illness, there are few studies in this regard. In the present paper, the authors present an organized literature review on the role of D-D in CKD until 2018. Additionally, the disadvantages and advantages of the revised procedures are debated, and the key issues of CKD are highlighted. The vital problem considered in recent years is that the researchers have tried to improve methods of preventing and treating CKD with different tests and methods. The authors found that increasing the plasma concentrations of D-D in CKD and diabetic nephropathy.

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  1. 1.

  2. 2.

  3. 3.

  4. 4.


  1. 1.

    Bishop ML, Fody EP, Schoeff LE (2013) Clinical chemistry: principles, techniques, and correlations. Lippincott Williams & Wilkins, Philadelphia

  2. 2.

    Campbell MF, Wein AJ, Kavoussi LR (2007) Campbell-Walsh urology: editor-in-chief, Alan J. Wein; editors, Louis R. Kavoussi… [et al.]. Urology. WB Saunders, Philadelphia

  3. 3.

    de Redactores G, Martínez-Castelao A, Górriz-Teruel JL, Bover-Sanjuán J, Segura-de la Morena J, Cebollada J et al (2014) Consensus document for the detection and management of chronic kidney disease. Nefrología (Engl Ed) 34:243–262

  4. 4.

    Sharain K, Hoppensteadt D, Bansal V, Singh A, Fareed J (2013) Progressive increase of inflammatory biomarkers in chronic kidney disease and end-stage renal disease. Clin Appl Thromb Hemost 19:303–308

  5. 5.

    Vahdat S (2018) The complex effects of adipokines in the patients with kidney disease. J Res Med Sci 23:60

  6. 6.

    Jalal DI, Chonchol M, Targher G (2010) Disorders of hemostasis associated with chronic kidney disease. In: Seminars in thrombosis and hemostasis, vol 31. Thieme Medical Publishers, pp 034–040

  7. 7.

    Domingueti CP, Fóscolo RB, Reis JS, Campos FMF, Dusse LMS, Carvalho MDG et al (2016) Association of haemostatic and inflammatory biomarkers with nephropathy in type 1 diabetes mellitus. J Diabetes Res 2016:2315260

  8. 8.

    Levey AS, Coresh J, Bolton K, Culleton B, Harvey KS, Ikizler TA et al (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39:S1–S266

  9. 9.

    Mohamed OMAA (2017) Determination of ProthrombinTime, activated partial thromboplastin time and D-dimer among sudanese patients with chronic renal failure. Sudan University of Science & Technology, Khartoum

  10. 10.

    Levey AS, Eckardt K-U, Tsukamoto Y, Levin A, Coresh J, Rossert J et al (2005) Definition and classification of chronic kidney disease: a position statement from kidney disease: improving global outcomes (KDIGO). Kidney Int 67:2089–2100

  11. 11.

    Mohammed NMS, Khalil HBE (2016) D-dimer levels in patients presenting chronic kidney disease in Sudan. Am J Med Med Sci 6:120–122

  12. 12.

    Levey AS, Coresh J (2012) Chronic kidney disease. Lancet 379:165–180

  13. 13.

    Zhao Y-Y (2013) Metabolomics in chronic kidney disease. Clin Chim Acta 422:59–69

  14. 14.

    Satko SG, Sedor JR, Iyengar SK, Freedman BI (2007) Familial clustering of chronic kidney disease. In: Seminars in dialysis, vol 20. Blackwell Publishing Ltd, Oxford, UK, pp 229–236

  15. 15.

    Park CW (2014) Diabetic kidney disease: from epidemiology to clinical perspectives. Diabetes Metab J 38:252–260

  16. 16.

    Hou X, Tian J, Geng J, Li X, Tang X, Zhang J et al (2016) MicroRNA-27a promotes renal tubulointerstitial fibrosis via suppressing PPARγ pathway in diabetic nephropathy. Oncotarget 7:47760

  17. 17.

    Pham TT, Sim JJ, Kujubu DA, Liu I-LA, Kumar VA (2007) Prevalence of nondiabetic renal disease in diabetic patients. Am J Nephrol 27:322–328

  18. 18.

    Packham DK, Alves TP, Dwyer JP, Atkins R, De Zeeuw D, Cooper M et al (2012) Relative incidence of ESRD versus cardiovascular mortality in proteinuric type 2 diabetes and nephropathy: results from the DIAMETRIC (Diabetes Mellitus Treatment for Renal Insufficiency Consortium) database. Am J Kidney Dis 59:75–83

  19. 19.

    He F, Xia X, Wu X, Yu X, Huang F (2013) Diabetic retinopathy in predicting diabetic nephropathy in patients with type 2 diabetes and renal disease: a meta-analysis. Springer, Berlin

  20. 20.

    McClelland AD, Herman-Edelstein M, Komers R, Jha JC, Winbanks CE, Hagiwara S et al (2015) miR-21 promotes renal fibrosis in diabetic nephropathy by targeting PTEN and SMAD7. Clin Sci 129:1237–1249

  21. 21.

    Tonolo G, Cherchi S (2014) Tubulointerstitial disease in diabetic nephropathy. Int J Nephrol Renov Dis 7:107

  22. 22.

    Remuzzi G, Macia M, Ruggenenti P (2006) Prevention and treatment of diabetic renal disease in type 2 diabetes: the BENEDICT study. J Am Soc Nephrol 17:S90–S97

  23. 23.

    Domingueti CP, Dusse LMS, Fóscolo RB, Reis JS, Annichino Bizzacchi JM, de Andrade-Orsi FL et al (2015) Von Willebrand factor, ADAMTS13 and D-dimer are correlated with different levels of nephropathy in type 1 diabetes mellitus. PLoS ONE 10:e0132784

  24. 24.

    Kanani DD, Vaidehipatel, Kiranchauhan D, Haridas DN (2017) Association of D-dimer in type 2 diabetes mellitus. Int J Adv Res (IJAR) 5:2139–2145

  25. 25.

    Seo E, Kim W-Y, Hur J, Kim H, Nam SA, Choi A et al (2016) The Hippo–Salvador signaling pathway regulates renal tubulointerstitial fibrosis. Sci Rep 6:31931

  26. 26.

    Li M-X, Liu B-C (2007) Epithelial to mesenchymal transition in the progression of tubulointerstitial fibrosis. Chin Med J 120:1925–1930

  27. 27.

    Zhao G, Zhao H, Tu L, Xu X, Zheng C, Jiang M et al (2010) Effects and mechanism of irbesartan on tubulointerstitial fibrosis in 5/6 nephrectomized rats. J Huazhong Univ Sci Technol (Med Sci) 30:48–54

  28. 28.

    Leung JY, Wilson HL, Voltzke KJ, Williams LA, Lee HJ, Wobker SE et al (2017) Sav1 loss induces senescence and Stat3 activation coinciding with tubulointerstitial fibrosis. Mol Cell Biol 37:e00565-16

  29. 29.

    Inoue K, Matsui I, Hamano T, Fujii N, Shimomura A, Nakano C et al (2012) Maxacalcitol ameliorates tubulointerstitial fibrosis in obstructed kidneys by recruiting PPM1A/VDR complex to pSmad3. Lab Invest 92:1686

  30. 30.

    Tracy RP (2003) Thrombin, inflammation, and cardiovascular disease: an epidemiologic perspective. Chest 124:49S–57S

  31. 31.

    Nwose EU, Richards RS, Jelinek HF, Kerr PG (2007) D-dimer identifies stages in the progression of diabetes mellitus from family history of diabetes to cardiovascular complications. Pathology 39:252–257

  32. 32.

    Adam SS, Key NS, Greenberg CS (2009) D-dimer antigen: current concepts and future prospects. Blood 113:2878–2887

  33. 33.

    Karami-Djurabi R, Klok FA, Kooiman J, Velthuis SI, Nijkeuter M, Huisman MV (2009) D-dimer testing in patients with suspected pulmonary embolism and impaired renal function. Am J Med 122:1050–1053

  34. 34.

    Epiney M, Boehlen F, Boulvain M, Reber G, Antonelli E, Morales M et al (2005) D-dimer levels during delivery and the postpartum. J Thromb Haemost 3:268–271

  35. 35.

    Righini M, Goehring C, Bounameaux H, Perrier A (2000) Effects of age on the performance of common diagnostic tests for pulmonary embolism. Am J Med 109:357–361

  36. 36.

    Robert-Ebadi H, Bertoletti L, Combescure C, Le Gal G, Bounameaux H, Righini M (2014) Effects of impaired renal function on levels and performance of D-dimer in patients with suspected pulmonary embolism. Thromb Haemost 112:614–620

  37. 37.

    Kitchenham B, Brereton OP, Budgen D, Turner M, Bailey J, Linkman S (2009) Systematic literature reviews in software engineering—a systematic literature review. Inf Softw Technol 51:7–15

  38. 38.

    Charband Y, Navimipour NJ (2016) Online knowledge sharing mechanisms: a systematic review of the state of the art literature and recommendations for future research. Inf Syst Front 18:1131–1151

  39. 39.

    Charband Y, Jafari-Navimipour N (2018) Knowledge sharing mechanisms in the education: a systematic review of the state of the art literature and recommendations for future research. Kybernetes 47:1456–1490

  40. 40.

    Pashazadeh A, Navimipour NJ (2018) Big data handling mechanisms in the healthcare applications: a comprehensive and systematic literature review. J Biomed Inform 82:47–62

  41. 41.

    Nowack R, Flores-Suarez F, Birck R, Schmitt W, Benck U (2011) Herbal treatments of glomerulonephritis and chronic renal failure: review and recommendations for research. J Pharmacogn Phytother 3:124–136

  42. 42.

    Fassett RG, Venuthurupalli SK, Gobe GC, Coombes JS, Cooper MA, Hoy WE (2011) Biomarkers in chronic kidney disease: a review. Kidney Int 80:806–821

  43. 43.

    Ghaderian SB, Hayati F, Shayanpour S, Mousavi SSB (2015) Diabetes and end-stage renal disease; a review article on new concepts. J Ren Inj Prev 4:28

  44. 44.

    Kordzadeh A, Parsa A, Askari A, Maddison B, Panayiotopoulos Y (2016) Presenting baseline coagulation of infra renal ruptured abdominal aortic aneurysm: a systematic review and pooled analysis. Eur J Vasc Endovasc Surg 51:682–689

  45. 45.

    Klein SJ, Brandtner AK, Lehner GF, Ulmer H, Bagshaw SM, Wiedermann CJ et al (2018) Biomarkers for prediction of renal replacement therapy in acute kidney injury: a systematic review and meta-analysis. Intensive Care Med 44:323–336

  46. 46.

    Kamitsuji H, Iida Y, Omura R, Taira K, Tsukada S, Kusumoto K et al (1982) Studies on fibrinolytic therapy in children with various renal diseases with special reference to changes of urinary FDP × D-dimer fragments. Nihon Jinzo Gakkai shi 24:1251–1259

  47. 47.

    Gordge M, Faint R, Rylance P, Ireland H, Lane D, Neild G (1989) Plasma D-dimer: a useful marker of fibrin breakdown in renal failure. Thromb Haemost 62:522–525

  48. 48.

    Akiyama T, Ikegami M, Imanishi M, Ishii T, Nishioka T, Uemura T et al (1990) Urinary FDP D-dimer and E fragments in renal transplantation. Nihon Hinyokika Gakkai zasshi (Jpn J Urol) 81:1680–1685

  49. 49.

    Tojima H, Hamaoka T, Fujita A, Suzuki A (1994) A case of pulmonary, pleural, and renal tuberculosis associated with DIC and a prolonged increase in D-dimer. Kekkaku (Tuberculosis) 69:419–424

  50. 50.

    Shibata T, Magari Y, Mizunaga S, Okabe E, Sumie A, Ishii T et al (1994) Significance of urinary fibrin/fibrinogen degradation product (FDP) D-dimer measured by highly sensitive ELISA method with a new monoclonal antibody (DD E72) in various renal diseases. Nihon Jinzo Gakkai Shi 36:805–812

  51. 51.

    Shibata T, Magari Y, Kamberi P, Ishii T, Tomo T, Yasumori R et al (1995) Significance of urinary fibrin/fibrinogen degradation products (FDP) D-dimer measured by a highly sensitive ELISA method with a new monoclonal antibody (DD E72) in various renal diseases. Clin Nephrol 44:91–95

  52. 52.

    Goldman M, McGrath G, Freeman M, Stevens S, Chen J (1995) D-dimer XDP correlates with fibrinolytic shutdown in renal transplant patients treated with anti-T-cell antibodies. Transpl Proc 27:1094–1098

  53. 53.

    Wei P, Xiumei L (1996) Effects of Bao Shen Kang on plasma Indothelin and D-dimer level in patients with chronic renal failure. J Guangdong Mid Coll 1:60

  54. 54.

    Arkel YS, Ku D-HW, Le P, Carr AM (2001) Comparison of a test for soluble fibrin polymer (TpPTM) with a standard quantitative ELISA for D-dimer in patients, without current thrombosis, who have cancer or renal disease. Thromb Haemost 86:1127–1128

  55. 55.

    Yang D-S, Wang L-Z, Han Z-M (2001) Relationship between white microthrombus, plasma D-dimer levels and renal vein thrombosis in children with nephrotic syndrome. J Xinxiang Med Coll 5:29

  56. 56.

    Gaze D, Crompton L, Collinson P (2007) Correlation of D-dimer and ntprobnp to cardiac troponin T but not cardiac troponin I in end stage renal disease patients receiving hemodialysis therapy. Clin Chem Lab Med 45:71

  57. 57.

    Zhang C, Yao X, Wang W, Yan X, Wu F (2010) D-dimer and CD146 aresensitive targets of diagnose for early kidney damage. J Modern Lab Med 25:134–135

  58. 58.

    Trent S et al (2010) D-dimer Testing in Patients with Suspected Pulmonary Embolism and Impaired Renal Function: karami-Djubani R, Frederikus K, Kooiman J, et al. Am J Med 2009; 122: 1050–3. J Emerg Med 38:558–559

  59. 59.

    Sande M et al (2010) D-dimer testing in patients with suspected pulmonary embolism and impaired renal function: Karami-Djurabi R, Klok FA, Kooiman J, et al. Am J Med 2009; 122: 1050–3. J Emerg Med 39:392

  60. 60.

    Narayanan S, Kolge SA (2010) Regarding the utility of D-dimer testing in patients with suspected pulmonary embolism and impaired renal function. Am J Med 123:e11

  61. 61.

    Yong M, Ling L, Fang D (2011) Changes of plasma fibrinogen, D-dimer, fibrin degradation products associated with kidney injury in children with Henoch–Schönlein purpura nephritis. Acta Univ Med Anhui 2:23

  62. 62.

    Ahmed EE (2011) Role of haemodialysis on prothrombin time, active partial thromboplastin time, and D dimer in late stage renal failure patients. Sudan University of Science and Technology, Khartoum

  63. 63.

    Chen J, Chen X, Zhang X (2011) Relationship between the level of plasma D-dimer urinary NAG mAlb and early renal injury in type 2 diabetes. Zhejiang J Lab Med 3:9

  64. 64.

    Barisione C, Ghigliotti G, Palombo D, Palmieri D, Spinella G, Pane B et al (2011) 402 Advanced abdominal aortic aneurysms display a specific inflammatory-proatherosclerotic profile with renal dysfunction raised D-dimer expanded CD14 ++ CD16+-monocytes having high CD143. Atheroscler Suppl 12:86

  65. 65.

    Huang J, Su J, Da W (2013) Changes of plasma fibrinogen, D-dimer, fibrin degradation products associated with kidney injury in patients with lupus nephritis. Liaoning J Tradit Chin Med 8:51

  66. 66.

    Carretón E, González-Miguel J, Montoya-Alonso J, Morchón R, Simón F, Passeri B et al (2013) D-dimer deposits in lungs and kidneys suggest its use as a marker in the clinical workup of dogs with heartworm (Dirofilaria immitis) disease. Vet Parasitol 191:182–186

  67. 67.

    Lindner G, Funk G-C, Pfortmueller CA, Leichtle AB, Fiedler GM, Schwarz C et al (2014) D-dimer to rule out pulmonary embolism in renal insufficiency. Am J Med 127:343–347

  68. 68.

    Erdem S, Amasyali AS, Aytac O, Onem K, Issever H, Sanli O (2014) Increased preoperative levels of plasma fibrinogen and D dimer in patients with renal cell carcinoma is associated with poor survival and adverse tumor characteristics. In: Urologic oncology: seminars and original investigations, vol 32. Elsevier, pp 1031–1040

  69. 69.

    Jekich B et al (2014) D-dimer to rule out pulmonary embolism in renal insufficiency: Lindner G, Funk GC, Pfortmueller CA, et al. Am J Med 2014; 127: 343–7. J Emerg Med 47:127–128

  70. 70.

    Thongprayoon C, Cheungpasitporn W, Chongnarungsin D (2014) Combined D-dimer and cardiac troponins for pulmonary embolism in renal insufficiency. Am J Med 127:e33

  71. 71.

    Xi X, Yang J, Wang Z, Zhu C, Li J, Liu S (2015) Potential utility of a renal function adjusted D-dimer cut-off value for improving the exclusion of pulmonary embolism. Zhonghua yi xue za zhi 95:2433–2436

  72. 72.

    Matsui S, Ishii J, Okuyama R, Takahashi H, Kawai H, Muramatsu T et al (2015) Combined assessment of acute kidney injury and increased plasma concentration of D-dimer is useful for evaluating 1-year mortality in patients hospitalized to coronary care units. Circulation 132:A13306

  73. 73.

    Roumpeas E, Kostoulas P, Polizopoulou Z, Koutinas CK, Mylonakis ME (2016) D-dimer concentrations in dogs with kidney disease with or without protein-losing nephropathy. Comp Clin Pathol 25:1007–1011

  74. 74.

    Lu J, Wang X, Chen Q, Chen M, Cheng L, Jiang H et al (2016) D-dimer is a predictor of 28-day mortality in critically Ill patients receiving continuous renal replacement therapy. Arch Med Res 47:356–364

  75. 75.

    Xi X (2016) Potential effect of a renal function adjusted D-dimer cutoff value to improve the exclusion of pulmonary embolism. Chest 149:A524

  76. 76.

    Li H, Feng G, Lin R, Zhang Y, Yao X (2016) Prognostic value of preoperative D-dimer in metastatic renal cell carcinoma patients with targeted therapy. Chin J Clin Oncol 43:992–996

  77. 77.

    Zhou B, Yan M (2017) The relationship research between β2-microglobulin and D-dimer concentration and kidney injury in pregnancy-induced hypertension patients. Int J Lab Med 38:1069–1071

  78. 78.

    Pfortmueller CA, Lindner G, Funk G-C, Leichtle AB, Fiedler GM, Schwarz C et al (2017) Role of D-dimer testing in venous thromboembolism with concomitant renal insufficiency in critical care. Intensive Care Med 43:470–471

  79. 79.

    Tan X, Chen G, Liu Y, Zhou L, He L, Liu D et al (2017) Serum D-dimer is a potential predictor for thromboembolism complications in patients with renal biopsy. Sci Rep 7:4836

  80. 80.

    Huang M-J, Wei R-B, Wang Y, Su T-Y, Di P, Li Q-P et al (2017) Blood coagulation system in patients with chronic kidney disease: a prospective observational study. BMJ Open 7:e014294

  81. 81.

    Stanifer JW, Landerman L, Pieper CF, Huffman KM, Kraus WE (2017) Relations of established aging biomarkers (IL-6, D-dimer, s-VCAM) to glomerular filtration rate and mortality in community-dwelling elderly adults. Clin Kidney J 11:377–382

  82. 82.

    Lin K, Jiang H, Chen H, Wang S, You Z, Lin C et al (2018) Association of pre-procedural D-dimer with contrast-induced acute kidney injury and long-term mortality after primary percutaneous coronary intervention. Circulation 138:A10458

  83. 83.

    Lin K, Guo Y, Zhu P (2018) GW29-e0906 association of pre-procedural D-dimer with contrast-induced acute kidney injury and long-term mortality after primary percutaneous coronary intervention. J Am Coll Cardiol 72:C126

  84. 84.

    Domingueti CP, Fóscolo RB, Dusse LMS, Reis JS, Carvalho MDG, Gomes KB et al (2018) 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 62:27–33

  85. 85.

    Elmenyawi AAI, Hassan A (2018) D-dimer, Von Willibrand factor, and ADAMTS13 in renal transplant recipients. J Med Sci Res 1:196

  86. 86.

    Erdem S, Verep S, Pazir Y, Tefik T, Tunc M, Ozcan F et al (2018) MP36-20 increased fibrinogen and D-dimer levels are associated with adverse tumor characteristics and decreased survival in renal cell carcinoma: the 2nd report with extended patient number and follow-up. J Urol 199:e467

  87. 87.

    Gao N, Yan C, Zhang G (2018) Changes of serum procalcitonin (PCT), C-reactive protein (CRP), interleukin-17 (IL-17), interleukin-6 (IL-6), high mobility group protein-B1 (HMGB1) and D-dimer in patients with severe acute pancreatitis treated with continuous renal replacement therapy (CRRT) and its clinical significance. Med Sci Monit 24:5881

  88. 88.

    Adams M, Irish A, Watts G, Oostryck R, Dogra G (2008) Hypercoagulability in chronic kidney disease is associated with coagulation activation but not endothelial function. Thromb Res 123:374–380

  89. 89.

    Vaziri N, Gonzales E, Wang J, Said S (1994) Blood coagulation, fibrinolytic, and inhibitory proteins in end-stage renal disease: effect of hemodialysis. Am J Kidney Dis 23:828–835

  90. 90.

    Schouten HJ, Geersing G, Koek H, Zuithoff NP, Janssen KJ, Douma RA et al (2013) Diagnostic accuracy of conventional or age adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism: systematic review and meta-analysis. BMJ 346:f2492

  91. 91.

    Dongre DTA, Govardhan DVP (2019) D-dimer in identifying progression of diabetes mellitus. World J Pharm Med Res 5:54–56

  92. 92.

    Naini AE, Vahdat S, Hedaiati ZP, Shahzeidi S, Pezeshki AH, Nasri H (2016) The effect of vitamin D administration on serum leptin and adiponectin levels in end-stage renal disease patients on hemodialysis with vitamin D deficiency: a placebo-controlled double-blind clinical trial. J Res Med Sci 21:1

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Correspondence to Sahar Vahdat.

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Significance Statement The authors provide valuable information relating to D-D levels in CKD explaining the findings and comparing them with those of previous researches. They demonstrated the classification of the reviewed practices, laying stress on their core characteristics.

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Vahdat, S., Shahidi, S. D-dimer Levels in Chronic Kidney Illness: A Comprehensive and Systematic Literature Review. Proc. Natl. Acad. Sci., India, Sect. B Biol. Sci. (2020).

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  • Chronic
  • Kidney illness
  • D-dimer levels
  • Systematic literature review