Liu C C, Haiu K T, Tsai H J, Lam K K
Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1990 Dec;13(4):268-73.
Iron deficiency is a frequent complication in maintenance hemodialysis patients. Red cell distribution width (RDW) was recently used as an indicator in early detection of iron deficiency. One hundred and thirty nine patients maintained on hemodialysis were studied for the usefulness of RDW in detection of iron deficiency. Serum ferritin less than 30 ug/dl was defined as iron deficiency in these patients. Another 69 patients with iron deficiency not entering hemodialysis were chosen as a control group. The sensitivity of RDW elevation to detect iron deficiency in chronic hemodialysis patients was only 36.7% which was much lower than that of the control group (62.3%). However, it was still more sensitive than microcytosis in the detection of iron deficiency in chronic hemodialysis patients because none of them showed microcytosis. The specificity and positive predictive value of RDW elevation in respect to iron deficiency were 62.4% and 9.6% respectively. This study demonstrated that the use of RDW in the detection of iron deficiency in chronic hemodialysis patients was superior to mean corpuscular volume but still limited.
缺铁是维持性血液透析患者常见的并发症。红细胞分布宽度（RDW）最近被用作早期检测缺铁的指标。对139例维持性血液透析患者进行了研究，以探讨RDW在检测缺铁方面的实用性。这些患者血清铁蛋白低于30μg/dl被定义为缺铁。另外选取69例未进行血液透析的缺铁患者作为对照组。RDW升高检测慢性血液透析患者缺铁的敏感性仅为36.7%，远低于对照组（62.3%）。然而，在检测慢性血液透析患者缺铁方面，它仍比小红细胞症更敏感，因为这些患者均未出现小红细胞症。RDW升高对缺铁的特异性和阳性预测值分别为62.4%和9.6%。本研究表明，RDW用于检测慢性血液透析患者缺铁优于平均红细胞体积，但仍有局限性。
