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红细胞分布宽度与腹膜透析相关性腹膜炎预后。

Red blood cell distribution width and peritoneal dialysis-associated peritonitis prognosis.

机构信息

Department of Nephrology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.

Department of Nephrology, Shaanxi Provincial Secondary People's Hospital, Xi'an, China.

出版信息

Ren Fail. 2020 Nov;42(1):613-621. doi: 10.1080/0886022X.2020.1786401.

DOI:10.1080/0886022X.2020.1786401
PMID:32611209
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7946038/
Abstract

Red blood cell distribution width (RDW) is a parameter of the heterogeneity of circulating erythrocyte size. Recent researches have pointed out a link among RDW, chronic kidney disease, and inflammation. We sought to investigate the prognostic value of baseline RDW in patients with peritoneal dialysis-associated peritonitis (PDAP). Our study included 337 peritonitis episodes experienced by 202 patients who were undergoing continuous ambulatory peritoneal dialysis (CAPD) at a single center from 2013 to 2018. Episodes were categorized according to the tertiles of baseline RDW levels (T1, <13.2%; T2, 13.2-14.3%; T3, >14.3%). Routine logistic regression and generalized estimating equation (GEE) were used to estimate the association between RDW and treatment failure, which was defined as relapse/recurrent episodes, catheter removal, or death during therapy. After adjusting for other potential predictors, RDW exhibited an incremental relationship with the risk of treatment failure. The baseline RDW of T3 indicated a 43% and 52% increased venture of treatment failure in logistic and GEE analyses, respectively, compared with T1. As a continuous variable, the fitting curve based on restricted cubic spiline showed that the relationship was nonlinearly but positively correlated. The multivariate model A (combined RDW with baseline age, albumin, serum ferritin, and duration on CAPD) showed an area under the curve of 0.671 (95% confidence interval, 0.5920.749) for the prediction of treatment failure. A Higher baseline level of RDW was significantly associated with a greater rate of treatment failure among PDAP episodes independent of other potential predictors.

摘要

红细胞体积分布宽度(RDW)是循环红细胞大小异质性的一个参数。最近的研究指出,RDW 与慢性肾脏病和炎症之间存在联系。我们旨在探讨基线 RDW 在腹膜透析相关性腹膜炎(PDAP)患者中的预后价值。本研究纳入了 2013 年至 2018 年在单中心接受持续非卧床腹膜透析(CAPD)的 202 名患者中的 337 次腹膜炎发作。根据基线 RDW 水平的三分位(T1,<13.2%;T2,13.2-14.3%;T3,>14.3%)将发作进行分类。常规逻辑回归和广义估计方程(GEE)用于估计 RDW 与治疗失败之间的关联,治疗失败定义为复发/再发、导管移除或治疗期间死亡。在调整其他潜在预测因素后,RDW 与治疗失败的风险呈递增关系。与 T1 相比,T3 的基线 RDW 分别在逻辑和 GEE 分析中预示着治疗失败风险增加 43%和 52%。作为一个连续变量,基于限制立方样条的拟合曲线显示,这种关系呈非线性但正相关。多变量模型 A(将 RDW 与基线年龄、白蛋白、血清铁蛋白和 CAPD 持续时间结合)对治疗失败的预测显示曲线下面积为 0.671(95%置信区间,0.5920.749)。较高的基线 RDW 水平与 PDAP 发作中治疗失败的发生率增加显著相关,独立于其他潜在预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6beb/7946038/53bacf281a59/IRNF_A_1786401_F0003_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6beb/7946038/f99b1d39e79d/IRNF_A_1786401_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6beb/7946038/33b9e8708ddd/IRNF_A_1786401_F0002_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6beb/7946038/53bacf281a59/IRNF_A_1786401_F0003_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6beb/7946038/f99b1d39e79d/IRNF_A_1786401_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6beb/7946038/33b9e8708ddd/IRNF_A_1786401_F0002_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6beb/7946038/53bacf281a59/IRNF_A_1786401_F0003_B.jpg

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本文引用的文献

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Ann Transl Med. 2019 Oct;7(20):581. doi: 10.21037/atm.2019.09.58.
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Peritoneal Dialysis-Associated Peritonitis.腹膜透析相关性腹膜炎
Clin J Am Soc Nephrol. 2019 Jul 5;14(7):1100-1105. doi: 10.2215/CJN.14631218. Epub 2019 May 8.
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The association between the red cell distribution width and diabetic nephropathy in patients with type-2 diabetes mellitus.红细胞分布宽度与 2 型糖尿病患者糖尿病肾病的关系。
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