Evaluation of D-dimer test in patients on chronic hemodialysis

2013 ◽  
Vol 8 (7-8) ◽  
pp. 254-257
Author(s):  
Branimir Vurusic ◽  
Sandra Oslakovic ◽  
Branko Ostricki ◽  
Zdravko Ivankovic ◽  
Mihajlo Kovacic ◽  
...  
Keyword(s):  
Chronic Hemodialysis ◽  
D Dimer

scholarly journals MO755SPONTANEOUS SOFT TISSUE HEMATOMAS IN ESRD PATIENTS WITH SYMPTOMATIC SARS-CO-V2  INFECTION – THE EXPERIENCE OF AN EMERGENCY NEPHROLOGY AND DIALYSIS DEPARTMENT

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Vacaroiu Ileana Adela ◽  
Cristiana David ◽  
Dragomirescu Razvan Ion Florin ◽  
Flavia Liliana Turcu ◽  
Dumitraciuc Cristina ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Anticoagulant Therapy ◽  
Psoas Muscle ◽  
Chronic Hemodialysis ◽  
Serum Urea ◽  
Infectious Disease Physician ◽  
Thrombotic Risk ◽  
Antiplatelet Medication ◽  
Esrd Patients ◽  
D Dimer

Abstract Background and Aims While actual proofs plead for an increased thrombotic risk in SARS-Co-V2 infection and need for anticoagulant therapy in severe cases, we report suspicious occurrence of hemorrhagic events in a series of ESRD patients. Method 59 patients with stage 5 CKD were hospitalized in a two months interval, since our hospital was designated for the admission of mild-severe SARS-Co-V2 patients exclusive. 8 patients were admitted for RRT initiation and 51 were maintenance dialysis patients admitted with SARS-Co-V2-associated complications. Beside hemodialysis and treatment of chronic complications of ESRD, all patients were treated, according to the stage and gravity of SARS-Co-V2 infection and under continuous supervision of an infectious disease physician, with antivirals, antibiotics, anticoagulants and IL-antagonists. Daily or at 2 days laboratory monitoring was performed and consisted in evaluation of inflammatory markers, clotting tests, complete hemogram, D-dimer testing, IL-1 and IL-6 serum levels, serum urea, creatinine and albumin. Results In 6 cases spontaneous soft tissue hematomas were noted, totalizing a number of 9 hematomas documented through ultrasound and CT-scan. In order of frequency, the locations were: 4 rectus abdominalis hematoma, 2 in the external oblique, 2 in gluteus maximus muscle, and one in the right psoas muscle. The source of the bleeding could not be identified in any patient. The occurrence of spontaneous hematomas was correlated with the D-dimer values (p=0.02), prolonged anticoagulation (over 7 days), albumin levels (p=0.01), platelets count (p=0.05). We found no correlation with the serum urea, creatinine, hemoglobin, INR, or with the dialysis age. In all these cases cough was severe. A conservative approach was instituted, with daily US monitoring, withdrawal of anticoagulants and antiplatelet medication, and blood transfusions. 2 patients necessitated surgical procedures and two deaths were recorded. Conclusion In this brief report, we observed that in chronic hemodialysis patients infected with SARS-Co-V2, risk of hemorrhagic manifestations may overcome the benefits of anticoagulant routine therapy. There is a need to explore further this risk in the future; until then, a careful individualized assessment of the safety and indications for anticoagulant therapy regimens is mandatory for ESRD patients with symptomatic new Coronavirus infection.

D-Dimer Tests Not Predictive of VTE in Elderly

2008 ◽  
Vol 41 (10) ◽  
pp. 12-13
Author(s):  
JANE SALODOF MACNEIL
Keyword(s):  
D Dimer

D-Dimer and CT Rule Out Pulmonary Embolism

2008 ◽  
Vol 1 (2) ◽  
pp. 11
Author(s):  
DAMIAN MCNAMARA
Keyword(s):  
Pulmonary Embolism ◽  
D Dimer ◽  
Rule Out

Tissue plasminogen activator as a novel diagnostic aid in acute pulmonary embolism

VASA ◽  
2014 ◽  
Vol 43 (6) ◽  
pp. 450-458 ◽  
Author(s):  
Julio Flores ◽  
Ángel García-Avello ◽  
Esther Alonso ◽  
Antonio Ruíz ◽  
Olga Navarrete ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Negative Predictive Value ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Predictive Value ◽  
Acute Pulmonary Embolism ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diagnostic Utility ◽  
Tissue Plasminogen ◽  
D Dimer

Background: We evaluated the diagnostic efficacy of tissue plasminogen activator (tPA), using an enzyme-linked immunosorbent assay (ELISA) and compared it with an ELISA D-dimer (VIDAS D-dimer) in acute pulmonary embolism (PE). Patients and methods: We studied 127 consecutive outpatients with clinically suspected PE. The diagnosis of PE was based on a clinical probability pretest for PE and a strict protocol of imaging studies. A plasma sample to measure the levels of tPA and D-dimer was obtained at enrollment. Diagnostic accuracy for tPA and D-dimer was determined by the area under the receiver operating characteristic (ROC) curve. Sensitivity, specificity, predictive values, and the diagnostic utility of tPA with a cutoff of 8.5 ng/mL and D-dimer with a cutoff of 500 ng/mL, were calculated for PE diagnosis. Results: PE was confirmed in 41 patients (32 %). Areas under ROC curves were 0.86 for D-dimer and 0.71 for tPA. The sensitivity/negative predictive value for D-dimer using a cutoff of 500 ng/mL, and tPA using a cutoff of 8.5 ng/mL, were 95 % (95 % CI, 88–100 %)/95 % (95 % CI, 88–100 %) and 95 % (95 % CI, 88–100 %)/94 %), respectively. The diagnostic utility to exclude PE was 28.3 % (95 % CI, 21–37 %) for D-dimer and 24.4 % (95 % CI, 17–33 %) for tPA. Conclusions: The tPA with a cutoff of 8.5 ng/mL has a high sensitivity and negative predictive value for exclusion of PE, similar to those observed for the VIDAS D-dimer with a cutoff of 500 ng/mL, although the diagnostic utility was slightly higher for the D-dimer.

Automated Latex Agglutination and ELISA Testing Yield Equivalent D-Dimer Results in Patients with Recent Myocardial Infarction

1999 ◽  
Vol 82 (11) ◽  
pp. 1412-1416 ◽  
Author(s):  
Wojciech Zareba ◽  
John Horan ◽  
Arthur Moss ◽  
Joel Kanouse ◽  
◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Elisa Test ◽  
Mean Value ◽  
Latex Agglutination ◽  
Test Results ◽  
Coronary Death ◽  
Elisa Testing ◽  
Strong Linear Correlation ◽  
Highly Correlated ◽  
D Dimer

SummaryOur previous prospective study of post-infarction patients described a strong and significant association of increased plasma D-dimer concentrations in those who experienced a subsequent coronary death or non-fatal myocardial infarction. In the present study, we compare results on stored plasma obtained two months after the index myocardial infarction from 1,038 patients of this trial, using a simple automated latex agglutination (LA) assay in parallel with the standard ELISA test. Results show a somewhat higher mean value for the LA assay (702 ± 1092 vs. 638 ± 986 ng/ml, p = 0.0002), a strong linear correlation of the two assays (r = 0.86) and 88% agreement for values below 500 ng/ml by the ELISA test. D-dimer concentrations determined by each assay were highly correlated in patients with subsequent coronary artery events (p = 0.93) and quartile values for both the LA and ELISA were equally predictive of such events (p = 0.003 and p = 0.001, respectively). This is the first demonstration that a latex agglutination assay for D-dimer can be used to assess the prognostic risk of recurrent coronary thrombotic disease after myocardial infarction

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