Summary
D dimer and other large fragments produced during the breakdown of crosslinked fibrin
may be measured by enzyme immunoassay using monoclonal antibodies. In 91 patients
with renal disease and varying degrees of renal dysfunction, plasma D dimer showed
no correlation with renal function, whereas FgE antigen, a fibrinogen derivative which
is known to be cleared in part by the kidney, showed a significant negative correlation
with creatinine clearance. Plasma concentrations of D dimer were, however, increased
in patients with chronic renal failure (244 ± 3l ng/ml) (mean ± SEM) and diabetic
nephropathy (308 ± 74 ng/ml), when compared with healthy controls (96 ± 13 ng/ml),
and grossly elevated in patients with acute renal failure (2,451 ± 1,007 ng/ml). The
results indicate an increase in fibrin formation and lysis, and not simply reduced
elimination of D dimer by the kidneys, and are further evidence of activated coagulation
in renal disease. D dimer appears to be a useful marker of fibrin breakdown in renal
failure.
Keywords
Renal failure - D dimer - Fibrin - Fibrinolysis
