International Journal of Clinical Science and Medical Research

Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a potentially serious condition requiring rapid and accurate diagnosis. D-dimer testing plays a central role in the diagnostic strategy because of its high sensitivity and negative predictive value, particularly in patients with low or intermediate clinical probability. However, its low specificity may lead to unnecessary imaging. Chronic kidney disease represents a challenging clinical setting, as D-dimer levels increase progressively with declining estimated glomerular filtration rate (eGFR), independently of thromboembolic events. This renal function–related elevation may considerably reduce specificity and complicate the interpretation of D-dimer results, potentially increasing the use of contrast-enhanced imaging in a population already vulnerable to renal complications. Therefore, adjusting D-dimer interpretation according to eGFR may improve diagnostic performance and help optimize the diagnostic strategy.

D-dimer, renal impairment, estimated glomerular filtration rate (eGFR), venous thromboembolism, diagnostic performance.

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