Association of serum D-dimer and fibrinogen with albumin and clinical thrombosis in children with nephrotic syndrome

Abstract Objective The aim of this study was to evaluate the relationship between serum fibrinogen, albumin, and D-dimer levels and clinical thrombosis factors in children with nephrotic syndrome (NS). Method This observational-analytical study compared clinical and laboratory data of 56 children (1–16 years) with NS who were hospitalized in the pediatric nephrology ward of hospital in 2023. Results The sample included 33 boys and 23 girls with a mean age of 6.3 years. Clinical thrombosis was identified in only 2 girls (3.6%). Moreover, elevated fibrinogen and D-dimer were found in 78.6% and 60.7% of the patients, respectively, without correlation with gender ( P > 0.05). Children with clinical thrombosis had significantly higher D-dimer levels (2224 ± 197.9 μg/L) than those without thrombosis (698.4 ± 818.08 μg/L; P = 0.01). Especially if the patient has nephrotic syndrome, D-dimer levels ≥ 2048.5 ng/ml may be a concern for clinical thrombosis. Conversely, no significant correlation was found between clinical thrombosis and albumin or fibrinogen levels ( P > 0.05). Higher levels of D-dimer (≥ 1000 ng/mL) correlated highly with fibrinogen levels ≥ 800 mg/dL ( P = 0.038). Conclusion Elevated levels of D-dimer may serve as a predictor for clinical thrombosis in children with NS. Further large-scale studies are needed to determine other risk factors and poor prognosis predictors in children with NS.