Hyun Young Youl, Kim Hyang, Lee Kyu-Beck
Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kidney Res Clin Pract. 2017 Sep;36(3):232-239. doi: 10.23876/j.krcp.2017.36.3.232. Epub 2017 Sep 30.
Red cell distribution width (RDW) is an emerging marker of inflammation and a predictor of high cardiovascular morbidity and mortality as well as all-cause mortality. A previous cross-sectional study showed that RDW was associated with microalbuminuria, an indicator of target organ damage. However, the longitudinal association of RDW and development of albuminuria is not known.
We analyzed 83,040 participants without chronic kidney disease (CKD) at baseline who underwent two health check-ups at a 4-year interval during 2005 to 2014. Urine albumin was determined by single urine dipstick semi-quantitative analysis, and incident albuminuria was defined as ≥ 1+ dipstick albumin at the second check-up. We used logistic regression analysis to determine the relationship between RDW and incident albuminuria.
Participants were divided into quartiles according to baseline RDW. After 4 years, 982 cases of incident albuminuria were observed. The cumulative incidences of albuminuria were 0.94, 1.05, 1.18, and 1.62% for the 1st through 4th quartiles of RDW, respectively. Multivariate logistic analysis showed that the odds ratios (95% confidence interval) for incident albuminuria compared to those in the 1st quartile were 1.11 (0.92-1.34), 1.26 (1.04-1.52), and 1.88 (1.58-2.24) for the 2nd, 3rd and 4th quartiles, respectively.
RDW was associated with development of albuminuria in relatively healthy Korean adults without CKD. Further research is needed to verify the role of RDW in the development of albuminuria and renal injury.
红细胞分布宽度（RDW）是一种新兴的炎症标志物，也是心血管疾病高发病率和死亡率以及全因死亡率的预测指标。先前的一项横断面研究表明，RDW与微量白蛋白尿相关，微量白蛋白尿是靶器官损伤的一个指标。然而，RDW与白蛋白尿发生之间的纵向关联尚不清楚。
我们分析了83040名基线时无慢性肾脏病（CKD）的参与者，他们在2005年至2014年期间每隔4年接受两次健康检查。通过单次尿试纸半定量分析测定尿白蛋白，将新发白蛋白尿定义为第二次检查时尿试纸白蛋白≥1+。我们使用逻辑回归分析来确定RDW与新发白蛋白尿之间的关系。
根据基线RDW将参与者分为四分位数。4年后，观察到982例新发白蛋白尿病例。RDW第一至第四四分位数的白蛋白尿累积发病率分别为0.94%、1.05%、1.18%和1.62%。多变量逻辑分析显示，与第一四分位数相比，第二、第三和第四四分位数新发白蛋白尿的比值比（95%置信区间）分别为1.11（0.92 - 1.34）、1.26（1.04 - 1.52）和1.88（1.58 - 2.24）。
在相对健康的无CKD韩国成年人中，RDW与白蛋白尿的发生相关。需要进一步研究来验证RDW在白蛋白尿发生和肾损伤中的作用。
