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Thromb Haemost 1989; 61(03): 522-525
DOI: 10.1055/s-0038-1646627
Original Article
Schattauer GmbH Stuttgart

Plasma D Dimer: A Useful Marker of Fibrin Breakdown in Renal Failure

M P Gordge
The Dept. of Renal Medicine, Institute of Urology, St. Philips Hospital, London, UK
,
R W Faint
The Dept. of Renal Medicine, Institute of Urology, St. Philips Hospital, London, UK
,
P B Rylance
The Dept. of Renal Medicine, Institute of Urology, St. Philips Hospital, London, UK
,
H Ireland
1   The Dept. of Haematology, Charing Cross and Westminster Medical School, London, UK
,
D A Lane
1   The Dept. of Haematology, Charing Cross and Westminster Medical School, London, UK
,
G H Neild
The Dept. of Renal Medicine, Institute of Urology, St. Philips Hospital, London, UK
› Author Affiliations
Further Information

Publication History

Received 18 October 1988

Accepted after revision 10 March 1989

Publication Date:
24 July 2018 (online)

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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
 

  • References

  • 1 Lane DA. Fibrinogen derivatives in plasma. Br J Haematol 1981; 47: 329-335
    CrossrefPubMedGoogle Scholar
  • 2 Merskey C, Johnson AJ, Lalezari P. Increase in fibrinogen and fibrin- related antigen in human serum due to in vitro lysis of fibrin by thrombin. J Clin Invest 1972; 51: 903-911
    CrossrefPubMedGoogle Scholar
  • 3 Gaffney PJ, Perry MJ. Unreliability of current serum fibrin degradation product (FDP) assays. Thromb Haemostas 1985; 53: 301-302
    PubMedGoogle Scholar
  • 4 Gordon YB, Martin MJ, Landon J, Chard T. The development of radioimmunoassays for fibrinogen fragments D and E. Br J Haematol 1975; 29: 109-119
    CrossrefPubMedGoogle Scholar
  • 5 Nossel HL, Yudelman I, Canfield RE, Butler VP, Spanondis K, Wilner GD, Qureshi GD. Measurement of fibrinopeptide A in human blood. J Clin Invest 1974; 54: 43-53
    CrossrefPubMedGoogle Scholar
  • 6 Kudryk B, Robinson D, Netre C, Hessel B, Blombäck M, Blombäck B. Measurement in human blood of fibrinogen/fibrin fragments containing the β 15-42 sequence. Thromb Res 1982; 25: 277-291
    CrossrefPubMedGoogle Scholar
  • 7 Gaffney PJ, Lane DA, Kakkar VV, Brasher M. Characterisation of a soluble D dimer-E complex in crosslinked fibrin digests. Thromb Res 1975; 7: 89-99
    CrossrefPubMedGoogle Scholar
  • 8 Lane DA, Preston FE, VanRoss ME, Kakkar VV. Characterisation of serum fibrinogen and fibrin fragments produced during disseminated intravascular coagulation. Br J Haematol 1978; 40: 609-615
    CrossrefPubMedGoogle Scholar
  • 9 Gaffney PJ, Creighton LJ, Perry MJ, Callus M, Thorpe R, Spitz M. Monoclonal antibodies to crosslinked fibrin degradation products (XL-FDP). Br J Haematol 1988; 68: 83-90
    CrossrefPubMedGoogle Scholar
  • 10 Rylatt DB, Blake AS, Cottis LE, Massingham DA, Fletcher WA, Masci PP, Whitaker AN, Elms M, Bunce I, Webber AJ, Wyatt D, Bundesen PG. An immunoassay for human D dimer using monoclonal antibodies. Thromb Res 1983; 31: 767-778
    CrossrefPubMedGoogle Scholar
  • 11 Depperman D, Andrassy K, Seeling H, Ritz E, Post D. β-thromboglobulin is elevated in renal failure without thrombosis. Thromb Res 1980; 17: 63-69
    CrossrefPubMedGoogle Scholar
  • 12 Parbtani A, Frampton G, Cameron JS. Measurement of platelet release substances in glomerulonephritis: a comparison of β-throm- boglobulin (BTG), platelet factor 4 (PF4) and serotonin assays. Thromb Res 1980; 19: 177-189
    CrossrefPubMedGoogle Scholar
  • 13 Lane DA, Ireland H, Knight I, Wolff S, Kyle P, Curtis JR. The significance of fibrinogen derivatives in human renal failure. Br J Haematol 1984; 56: 251-260
    CrossrefPubMedGoogle Scholar
  • 14 Ilo A, Rutherford WE, Wochner RD, Spilberg I, Sherman LA. The roles of renal catabolism and uraemia in modifying the clearance of fibrinogen and its degredative fragments D and E. J Lab Clin Med 1976; 87: 934-946
    PubMedGoogle Scholar
  • 15 Lane DA, Markwick J, Thompson E, Ireland H. Experimental evidence for renal catabolism of fibrin fragment β 15-42. Thromb Res 1984; 33: 571-581
    CrossrefPubMedGoogle Scholar
  • 16 Purkerson ML, Hoffsten PE, Klahr S. Pathogenesis of the glomerulopathy associated with renal infarction in rats. Kidney Int 1976; 9: 407-417
    CrossrefPubMedGoogle Scholar
  • 17 Ludlam CA, Cash JD. Studies on the liberation of β thromboglobulin from human platelets in vitro. Br J Haematol 1976; 33: 239-247
    CrossrefPubMedGoogle Scholar
  • 18 Whitaker AN, Elms MJ, Masci PP, Bundesen PG, Rylatt DB, Webber AJ, Bunce IH. Measurement of cross linked fibrin derivatives in plasma: an immunoassay using monoclonal antibodies. J Clin Pathol 1984; 37: 882-887
    CrossrefPubMedGoogle Scholar
  • 19 von Clauss A. Gerinnungsphysiologische Schnellmethode zur Bestimmung des Fibrinogens. Acta Haematol (Basle) 1957; 17: 237-246
    CrossrefPubMedGoogle Scholar
  • 20 Maack T, Johnson V, Kau ST, Figueiredo J, Sigulem D. Renal filtration, transport, and metabolism of low-molecular-weight proteins: a review. Kidney Int 1979; 16: 251-270
    CrossrefPubMedGoogle Scholar
  • 21 Martin KJ, Hruska KA, Lewis J, Anderson C, Slatopolsky E. The renal handling of parathyroid hormones. Role of peritubular uptake and glomerular filtration J Clin Invest 1977; 60: 808-814
    CrossrefPubMedGoogle Scholar
  • 22 Pizzo SV, Pasqua JJ. The clearance of human fibrinogen fragments D1, D2, D3and fibrin fragment D1 dimer in mice. Biochim Biophys Acta 1982; 718: 177-184
    CrossrefPubMedGoogle Scholar
  • 23 Briggs JD, Prentice CR M, Hutton MM, Kennedy AC, McNicol GP. Serum and urine fibrinogen-fibrin-related antigen (FR antigen) levels in renal disease. Br Med J 1972; 4: 82-85
    CrossrefPubMedGoogle Scholar
  • 24 Sakakibara K, Nagase M, Takada Y, Takada A. Relationship between urinary fibrinogen degradation products and various types of chronic nephritis. Thromb Res 1987; 45: 403-411
    CrossrefPubMedGoogle Scholar
  • 25 Kamitsuji H, Kusumoto K, Taira K, Iida Y, Nakajima M, Fukui H. Localization of intrarenal cross-linked fibrin in children with various renal diseases. Nephron 1983; 35: 94-99
    CrossrefPubMedGoogle Scholar
  • 26 Scott WL, Francis CW, Knutson DW, Marder VJ. Specific identification of urinary fibrinogen, fibrinogen degradation products, and cross-linked fibrin degradation products in renal diseases and after renal transplantation. J Lab Clin Med 1986; 107: 534-543
    PubMedGoogle Scholar
  • 27 Kamitsuji H, Whitworth JA, Dowling JP, Kincaid-Smith P. Urinary crosslinked fibrin degradation products in glomerular disease. Am J Kidney Dis 1986; 7: 452-455
    CrossrefPubMedGoogle Scholar
  • 28 Klahr S, Schreiner G, Ichikawa I. The progression of renal disease. New Engl J Med 1988; 318: 1657-1666
    CrossrefPubMedGoogle Scholar
  • 29 Wardle EN. Fibrin in renal disease: functional considerations. Clin Nephrol 1974; 2: 85-92
    PubMedGoogle Scholar
  • 30 Kessler CM, Bell WR. The effect of homologous thrombin and fibrinogen degradation products on fibrinogen synthesis in rabbits. J Lab Clin Med 1979; 93: 768-782
    PubMedGoogle Scholar
  • 31 Franks JJ, Kirsch RE, Frith LO C, Purves LR, Franks WT, Mason P, Saunders SJ. Effect of fibrinogenolytic products D and E on fibrinogen and albumin synthesis in the rat. J Clin Invest 1981; 67: 575-580
    CrossrefPubMedGoogle Scholar