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血清 D-二聚体是预测肾活检患者血栓栓塞并发症的潜在指标。

Serum D-dimer is a potential predictor for thromboembolism complications in patients with renal biopsy.

机构信息

Department of Nephrology, The Second Xiangya Hospital of Central South University. Renal Research Institute of Central South University, Key Lab of Kidney Disease and Blood Purification in Hunan, Changsha, China.

出版信息

Sci Rep. 2017 Jul 6;7(1):4836. doi: 10.1038/s41598-017-05210-6.

Abstract

Renal biopsy has been widely recommended in clinic to determine the histological patterns of kidney disease. To prevent bleeding complications, patients should routinely stop anticoagulants prior to renal biopsy. However, patients with kidney disease are susceptible to thromboembolisms, particularly in those with severe hypoalbuminemia. This study was designed to investigate the application of serum D-dimer as a predictor for thrombotic events after renal biopsy. 400 consecutive native renal biopsies were prospectively included in this 2-month follow-up study. The overall incidence of bleeding and thrombotic complication is 4%, including hematuria or large perinephric hematoma (2.5%, n = 10) and thrombotic complication (1.5%, n = 6). Compared to low serum D-dimer (<2.00 μg/ml), subjects in the group of high serum D-dimer (≥2.00 μg/ml) were more incline to develop thrombotic complications (9.1% versus 0.3%; RR, 30.33; p < 0.001). D-dimer correlated positively with age (r = 0.258, P < 0.001). Inverse correlations were found for albumin (r = -0.339, P < 0.001). Taken together, patients with high serum D-dimer carry an increased risk of thrombotic complications after renal biopsy. Our findings suggest that serum D-dimer can serve as a potential predictor for thrombotic events in patients with kidney disease. Further cautions should be given to these subjects.

摘要

肾活检已广泛应用于临床,以确定肾脏疾病的组织学模式。为了预防出血并发症,患者在肾活检前通常应常规停止抗凝治疗。然而,肾病患者容易发生血栓栓塞,尤其是在严重低白蛋白血症的患者中。本研究旨在探讨血清 D-二聚体作为肾活检后血栓事件预测因子的应用。400 例连续的原发性肾活检前瞻性纳入本 2 个月随访研究。出血和血栓并发症的总发生率为 4%,包括血尿或大肾周血肿(2.5%,n=10)和血栓并发症(1.5%,n=6)。与低血清 D-二聚体(<2.00μg/ml)相比,高血清 D-二聚体(≥2.00μg/ml)组发生血栓并发症的可能性更高(9.1%对 0.3%;RR,30.33;p<0.001)。D-二聚体与年龄呈正相关(r=0.258,P<0.001)。与白蛋白呈负相关(r=-0.339,P<0.001)。总之,高血清 D-二聚体的患者在肾活检后发生血栓并发症的风险增加。我们的研究结果表明,血清 D-二聚体可作为肾病患者血栓事件的潜在预测因子。对这些患者应给予进一步的关注。

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