Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China.
J Int Med Res. 2020 Nov;48(11):300060520966899. doi: 10.1177/0300060520966899.
This study was performed to determine the association of D-dimers measured at the time of admission with the development of acute kidney injury (AKI) in pregnant women.
We retrospectively analyzed the data of 625 women who developed AKI and 628 normal pregnant women admitted to our hospital from January 2014 to December 2018. The primary endpoint of the study was the development of AKI in pregnant women, and the secondary endpoint was the development of dialysis and death in women with AKI. Univariate and multivariate analyses were conducted.
The D-dimer concentration was significantly higher in patients with than without pregnancy-related AKI (PR-AKI). Multivariate logistic regression showed that a D-dimer concentration of >1108 ng/mL was an independent predictor of PR-AKI. The area under the curve of the D-dimer concentration as a prognostic indicator of PR-AKI was 0.652 (95% confidence interval, 0.622-0.683), that for patients with PR-AKI undergoing dialysis was 0.819 (95% confidence interval, 0.709-0.928), and that for patients who died was 0.828 (95% confidence interval, 0.670-0.986).
The D-dimer concentration is significantly associated with the development of AKI in pregnant patients and may increase the risk of dialysis and death in women with AKI.
本研究旨在确定入院时 D-二聚体的检测与孕妇急性肾损伤（AKI）的发生之间的关联。
我们回顾性分析了 2014 年 1 月至 2018 年 12 月期间我院收治的 625 例发生 AKI 的孕妇和 628 例正常孕妇的临床资料。本研究的主要终点为孕妇 AKI 的发生，次要终点为 AKI 妇女中透析和死亡的发生。进行了单因素和多因素分析。
与无妊娠相关 AKI（PR-AKI）患者相比，PR-AKI 患者的 D-二聚体浓度明显升高。多因素逻辑回归分析表明，D-二聚体浓度＞1108ng/ml 是 PR-AKI 的独立预测因子。D-二聚体浓度作为 PR-AKI 预后指标的曲线下面积为 0.652（95%置信区间，0.622-0.683），对行透析治疗的 PR-AKI 患者为 0.819（95%置信区间，0.709-0.928），对死亡患者为 0.828（95%置信区间，0.670-0.986）。
D-二聚体浓度与孕妇 AKI 的发生显著相关，可能增加 AKI 妇女透析和死亡的风险。
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