Fukasawa Hirotaka, Ishibuchi Kento, Kaneko Mai, Niwa Hiroki, Yasuda Hideo, Kumagai Hiromichi, Furuya Ryuichi
Renal Division, Department of Internal Medicine, Iwata City Hospital, Iwata, Shizuoka, Japan.
First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Ther Apher Dial. 2017 Dec;21(6):565-571. doi: 10.1111/1744-9987.12579. Epub 2017 Sep 29.
Red blood cell distribution width (RDW) is an index of red blood cell variability that is usually used to differentiate the cause of anemia. However, clinical evidence for the relationship between RDW and mortality in hemodialysis patients is still lacking. We performed a single center, prospective longitudinal study. During more than 5 years of follow-up in 80 patients undergoing maintenance hemodialysis, 34 patients (42.5%) died. In the Kaplan-Meier curve analyses, higher RDW levels (≥ 14.9%) were significantly associated with all-cause and cardiovascular mortality (log-rank test, P < 0.05, each). In multivariate Cox proportional hazard models, each 1.0% increase in RDW value predicted an estimated 25% higher risk of mortality (P < 0.05) and a 40% higher risk of cardiovascular mortality (P < 0.05). In conclusion, higher RDW value was a significant predictor for all-cause and cardiovascular mortality in patients undergoing maintenance hemodialysis.
红细胞分布宽度（RDW）是红细胞变异性的一个指标，通常用于鉴别贫血的病因。然而，关于RDW与血液透析患者死亡率之间关系的临床证据仍然不足。我们开展了一项单中心前瞻性纵向研究。在对80例维持性血液透析患者进行的5年多随访中，34例患者（42.5%）死亡。在Kaplan-Meier曲线分析中，较高的RDW水平（≥14.9%）与全因死亡率和心血管死亡率显著相关（对数秩检验，P均<0.05）。在多变量Cox比例风险模型中，RDW值每增加1.0%，预测死亡风险估计升高25%（P<0.05），心血管死亡风险升高40%（P<0.05）。总之，较高的RDW值是维持性血液透析患者全因死亡率和心血管死亡率的重要预测指标。
