Mucsi Istvan, Ujszaszi Akos, Czira Maria E, Novak Marta, Molnar Miklos Z
Int Urol Nephrol. 2014 Mar;46(3):641-51. doi: 10.1007/s11255-013-0530-z.
Red cell distribution width (RDW), a parameter routinely reported as part of the complete blood count, is associated with increased morbidity and mortality risk in different patient populations. No published data are available about the association between RDW and mortality in kidney transplant recipients.
We collected socio-demographic, clinical parameters, medical and transplant history and laboratory data at baseline in 723 prevalent kidney transplant recipients between June and October 2008 [mean age 51 ± 13 (SD) years, 56 % men, 21 % diabetics]. Associations between baseline RDW values and all-cause mortality over 3 years were examined in unadjusted and adjusted models.
Increasing RDW was associated with increased mortality in both unadjusted [(HR(1 % increase) = 1.63; 95 % CI 1.41-1.89) and (HR(>median) = 2.74; 95 % CI 1.68-4.48)] and fully adjusted models [(HR(1 % increase) = 1.60; 95 % CI 1.27-1.89) and (HR(>median) = 1.33; 95 % CI 0.76-2.35)]. In reclassification analyses, RDW improved the predictive value of all-cause mortality prediction models [the net reclassification improvement (NRI) was 0.189; p < 0.001].
RDW, a cheap and readily available but largely neglected parameter independently, predicts mortality in prevalent kidney transplant recipients and could potentially been used in everyday risk assessment of kidney transplant recipients.
红细胞分布宽度（RDW）是全血细胞计数中常规报告的一个参数，在不同患者群体中与发病和死亡风险增加相关。目前尚无关于肾移植受者中RDW与死亡率之间关联的已发表数据。
我们收集了2008年6月至10月期间723例现患肾移植受者的社会人口统计学、临床参数、医疗和移植史以及基线实验室数据[平均年龄51±13（标准差）岁，男性占56%，糖尿病患者占21%]。在未调整和调整模型中检查基线RDW值与3年全因死亡率之间的关联。
在未调整模型[（1%增加的风险比（HR）=1.63；95%置信区间1.41 - 1.89）和（高于中位数的HR = 2.74；95%置信区间1.68 - 4.48）]和完全调整模型[（1%增加的HR = 1.60；95%置信区间1.27 - 1.89）和（高于中位数的HR = 1.33；95%置信区间0.76 - 2.35）]中，RDW升高均与死亡率增加相关。在重新分类分析中，RDW提高了全因死亡率预测模型的预测价值[净重新分类改善（NRI）为0.189；p < 0.001]。
RDW是一个廉价且易于获得但在很大程度上被忽视的参数，可独立预测现患肾移植受者的死亡率，并可能用于肾移植受者的日常风险评估。
