title: D-dimer Is a Predictor of 28-Day Mortality in Critically Ill Patients Receiving Continuous Renal Replacement Therapy.
abstract: Continuous renal replacement therapy (CRRT) is an important treatment in the intensive care unit (ICU). Nevertheless, the outcome of CRRT remains unclear. It is important to find a useful and easy indicator to predict the prognosis in patients on CRRT treatment. We undertook this study to observe the association between serum D-dimer level and mortality of ICU patients in the treatment of CRRT.
  
  
  
  A total of 149 patients who received CRRT were enrolled in our study. We observed the correlation of D-dimer with the information of biochemical parameters, acute physiology and chronic health evaluation II (APACHE II) score. We analyzed the association between serum D-dimer level before CRRT and 28-d mortality retrospectively. Furthermore, we used Cox regression analysis to assess whether D-dimer could be the independent risk factor for mortality.
  
  
  
  There were significant correlations between D-dimer and C-reaction protein (r2= 0.033, p = 0.026), creatinine (r2= 0.066, p = 0.002) and APACHE II (r2= 0.036, p = 0.021). The difference in 28-d mortality risk between elevated D-dimer group and normal D-dimer group was significant (HR 2.872, 95% CI 1.563-5.278, p = 0.001), and the elevated D-dimer level was an independent risk factor for 28-d mortality (HR 2.067, 95% CI 1.104-3.872, p = 0.023). The difference in 28-d mortality was significant between groups (p <0.001). ROC curves showed that the area under the curve (AUC) of D-dimer was 0.763.
  
  
  
  The present study demonstrates that serum D-dimer could be a useful and easy prognostic variable of 28-d mortality in critically ill patients who received CRRT.
authors.affiliation: Intensive Care Unit, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Lu
authors.affiliation: Intensive Care Unit, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Wang
authors.affiliation: Intensive Care Unit, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China.
authors.forename: Qiuhua
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Intensive Care Unit, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China.
authors.forename: Mingqi
authors.initials: M
authors.lastname: Chen
authors.affiliation: Intensive Care Unit, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Cheng
authors.affiliation: Intensive Care Unit, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Jiang
authors.affiliation: The First Clinical College, Nanjing University of Traditional Chinese Medicine, Nanjing, China. Electronic address: pr_zhiguangsun@163.com.
authors.forename: Zhiguang
authors.initials: Z
authors.lastname: Sun
mesh_terms: D018806:APACHE; D058186:Acute Kidney Injury / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D016638:Critical Illness; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012044:Regression Analysis; D017582:Renal Replacement Therapy; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D003404:Creatinine
keywords: Acute kidney injury; Continuous renal replacement therapy; Critical care; D-dimer