Nephrology Division, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea.
Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Kidney Res Clin Pract. 2016 Jun;35(2):114-8. doi: 10.1016/j.krcp.2016.03.003. Epub 2016 May 24.
In this study, we assessed whether red blood cell distribution width (RDW) was associated with all-cause mortality in patients on peritoneal dialysis (PD) and evaluated its prognostic value.
This study included 136 patients who had RDW levels at PD initiation from January 2007 to January 2014 at the Presbyterian Medical Center and Seoul St. Mary's Hospital. We divided these patients into 2 groups (survivors vs. nonsurvivors), compared their clinical characteristics, and analyzed the predictors of survival.
The study included 79 men and 57 women, with a mean age of 54 years (range, 15-85 years). The mean follow-up duration was 32 months (range, 1-80 months). Of 136 patients, 14 died during the follow-up period. When clinical characteristics of survivors (n = 122) and nonsurvivors (n = 14) were compared, no differences were identified, with the exception of serum albumin, total iron-binding capacity (TIBC), left ventricular ejection fraction, total leukocyte count, and RDW value. Survivors had higher serum albumin (3.4 ± 0.5 vs. 3.0 ± 0.5 g/dL, P < 0.001) and left ventricular ejection fraction (56.8 ± 9.8 vs. 48.7 ± 12.8, P = 0.040) and lower TIBC (213.4 ± 40.9 vs. 252.8 ± 65.6, P = 0.010), total leukocyte counts (6.9 × 10(3)/μL vs. 8.6 × 10(3)/μL, P = 0.009), and serum RDW values (13.9 ± 1.7 vs. 16.0 ± 1.8, P < 0.001). Patients with high RDW levels (≥ 14.8) showed significantly higher all-cause mortality than patients with low RDW levels (< 14.8, P < 0.001). In multivariate-adjusted Cox analysis, RDW and TIBC at the start of PD were independent risk predictors for all-cause mortality.
RDW could be an additive predictor for all-cause mortality in patients on PD.
本研究旨在评估红细胞分布宽度（RDW）是否与腹膜透析（PD）患者的全因死亡率相关，并评估其预后价值。
本研究纳入了 2007 年 1 月至 2014 年 1 月在长老会医疗中心和首尔圣玛丽医院接受 PD 治疗且基线时具有 RDW 水平的 136 例患者。我们将这些患者分为两组（存活组和非存活组），比较其临床特征，并分析生存的预测因素。
本研究纳入了 79 名男性和 57 名女性，平均年龄为 54 岁（范围 15-85 岁）。平均随访时间为 32 个月（范围 1-80 个月）。在 136 例患者中，有 14 例在随访期间死亡。比较存活组（n=122）和非存活组（n=14）的临床特征时，除血清白蛋白、总铁结合力（TIBC）、左心室射血分数、白细胞总数和 RDW 值外，两组间无差异。存活组的血清白蛋白（3.4±0.5 比 3.0±0.5 g/dL，P<0.001）和左心室射血分数（56.8±9.8 比 48.7±12.8，P=0.040）更高，而 TIBC（213.4±40.9 比 252.8±65.6，P=0.010）、白细胞总数（6.9×10(3)/μL 比 8.6×10(3)/μL，P=0.009）和血清 RDW 值（13.9±1.7 比 16.0±1.8，P<0.001）更低。RDW 水平较高（≥14.8）的患者全因死亡率显著高于 RDW 水平较低（<14.8，P<0.001）的患者。在多变量调整的 Cox 分析中，PD 起始时的 RDW 和 TIBC 是全因死亡率的独立危险因素。
RDW 可能是 PD 患者全因死亡率的附加预测指标。
