PDF(Pubmed)
Abstract：
UNASSIGNED: Coagulation disorders play a key role in chronic kidney disease, and the formation or elevation of plasma D-dimer levels reflects activation of the coagulation system. However, its relationship with the severity and progression of kidney disease in IgA nephropathy (IgAN) remains unclear.
UNASSIGNED: We assessed 1818 patients with IgAN diagnosed between 2002 and 2019 at the First Affiliated Hospital, Zhejiang University School of Medicine. Plasma D-dimer levels were measured at the time of the renal biopsy. The association between plasma D-dimer levels and kidney disease progression events, defined as a 50% decline in eGFR and end-stage kidney disease (ESKD), was tested using restricted cubic splines and Cox proportional hazard models.
UNASSIGNED: The median plasma D-dimer level was 220 (170-388.5) µg/L FEU, which was significantly higher than healthy controls 170 (170-202) µg/L FEU. Plasma D-dimer levels were positively correlated with proteinuria (r = 0.211, p < 0.001) and serum galactose-deficient IgA1 (r = 0.226, p = 0.004) and negatively correlated with eGFR (r=-0.127, p < 0.001) and Oxford T (p < 0.001) and C (p = 0.004) scores. After a median follow-up of 25.67 (13.03-47.44) months, 126 (6.93%) patients experienced composite kidney disease progression events. Higher plasma D-dimer levels were associated with an increased risk of kidney disease progression events (hazard ratio, 1.73; 95% confidence interval [95% CI], 1.40-2.23) per ln-transformed plasma D-dimer (p < 0.001), after adjustment for sex, age, proteinuria, Mean arterial pressure (MAP) and Oxford classification scores. In reference to the first tertile of plasma D-dimer, hazard ratios were 1.48 (95% CI, 0.76-2.88) for the second tertile, 3.03 (95% CI, 1.58-5.82) for the third tertile.
UNASSIGNED: High plasma D-dimer levels were associated with the progression of kidney disease severity in IgA nephropathy.
UNASSIGNED: We assessed 1818 patients with IgAN diagnosed between 2002 and 2019 at the First Affiliated Hospital, Zhejiang University School of Medicine. Plasma D-dimer levels were measured at the time of the renal biopsy. The association between plasma D-dimer levels and kidney disease progression events, defined as a 50% decline in eGFR and end-stage kidney disease (ESKD), was tested using restricted cubic splines and Cox proportional hazard models.
UNASSIGNED: The median plasma D-dimer level was 220 (170-388.5) µg/L FEU, which was significantly higher than healthy controls 170 (170-202) µg/L FEU. Plasma D-dimer levels were positively correlated with proteinuria (r = 0.211, p < 0.001) and serum galactose-deficient IgA1 (r = 0.226, p = 0.004) and negatively correlated with eGFR (r=-0.127, p < 0.001) and Oxford T (p < 0.001) and C (p = 0.004) scores. After a median follow-up of 25.67 (13.03-47.44) months, 126 (6.93%) patients experienced composite kidney disease progression events. Higher plasma D-dimer levels were associated with an increased risk of kidney disease progression events (hazard ratio, 1.73; 95% confidence interval [95% CI], 1.40-2.23) per ln-transformed plasma D-dimer (p < 0.001), after adjustment for sex, age, proteinuria, Mean arterial pressure (MAP) and Oxford classification scores. In reference to the first tertile of plasma D-dimer, hazard ratios were 1.48 (95% CI, 0.76-2.88) for the second tertile, 3.03 (95% CI, 1.58-5.82) for the third tertile.
UNASSIGNED: High plasma D-dimer levels were associated with the progression of kidney disease severity in IgA nephropathy.
摘要：
■凝血障碍在慢性肾脏病中起关键作用，血浆D-二聚体水平的形成或升高反映了凝血系统的激活。然而,其与IgA肾病（IgAN）肾脏疾病的严重程度和进展的关系尚不清楚。
■我们评估了2002年至2019年在第一附属医院诊断的1818例IgAN患者，浙江大学医学院.在肾活检时测量血浆D-二聚体水平。血浆D-二聚体水平与肾脏疾病进展事件之间的关系,定义为eGFR和终末期肾病（ESKD）下降50％，使用受限三次样条和Cox比例风险模型进行了测试。
■血浆D-二聚体水平中位数为220（170-388.5）µg/LFEU，显着高于健康对照组170（170-202）µg/LFEU。血浆D-二聚体水平与蛋白尿(r=0.211,p<0.001)、血清半乳糖缺乏IgA1(r=0.226,p=0.004)呈正相关,与eGFR(r=-0.127,p<0.001)、OxfordT(p<0.001)、C(p=0.004)评分呈负相关。在中位随访25.67(13.03-47.44)个月后，126例（6.93%）患者出现复合肾脏疾病进展事件。较高的血浆D-二聚体水平与肾脏疾病进展事件的风险增加相关(风险比,1.73；95%置信区间[95%CI]，1.40-2.23)/ln-转化血浆D-二聚体(p<0.001)，在性别调整后，年龄,蛋白尿,平均动脉压（MAP）和牛津分类评分。关于血浆D-二聚体的第一个三分位数，第二三分位数的风险比为1.48(95%CI，0.76-2.88)，第三三分位数为3.03（95%CI，1.58-5.82）。
■高血浆D-二聚体水平与IgA肾病肾病严重程度的进展相关。
■我们评估了2002年至2019年在第一附属医院诊断的1818例IgAN患者，浙江大学医学院.在肾活检时测量血浆D-二聚体水平。血浆D-二聚体水平与肾脏疾病进展事件之间的关系,定义为eGFR和终末期肾病（ESKD）下降50％，使用受限三次样条和Cox比例风险模型进行了测试。
■血浆D-二聚体水平中位数为220（170-388.5）µg/LFEU，显着高于健康对照组170（170-202）µg/LFEU。血浆D-二聚体水平与蛋白尿(r=0.211,p<0.001)、血清半乳糖缺乏IgA1(r=0.226,p=0.004)呈正相关,与eGFR(r=-0.127,p<0.001)、OxfordT(p<0.001)、C(p=0.004)评分呈负相关。在中位随访25.67(13.03-47.44)个月后，126例（6.93%）患者出现复合肾脏疾病进展事件。较高的血浆D-二聚体水平与肾脏疾病进展事件的风险增加相关(风险比,1.73；95%置信区间[95%CI]，1.40-2.23)/ln-转化血浆D-二聚体(p<0.001)，在性别调整后，年龄,蛋白尿,平均动脉压（MAP）和牛津分类评分。关于血浆D-二聚体的第一个三分位数，第二三分位数的风险比为1.48(95%CI，0.76-2.88)，第三三分位数为3.03（95%CI，1.58-5.82）。
■高血浆D-二聚体水平与IgA肾病肾病严重程度的进展相关。
