Abstract
Background and Aims
The 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), which remains unknown.
Method
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, generalized estimating equation and restricted cubic spline were used to estimate the association between RDW and treatment failure, which was defined as relapse or recurrent episodes, catheter removal, or death during peritonitis therapy. The predictive performance of multivariate models including RDW and other potential predictors were also evaluated.
Results
After adjusting for other potential predictors, RDW exhibited an incremental relationship with the risk of treatment failure. The baseline RDW of >14.3% (T3) indicated a 43% and 52% increased venture of treatment failure in logistic and GEE analyses, respectively, compared with < 13.2% (T1). As a continuous variable, the fitting curve based on restricted cubic spiline showed that the relationship was nolinearly but positively correlated. The multivariate model A (combined RDW with age, duration on PD, albumin and ferritin) showed an area under the curve (AUC) of 0.671 (95% CI, 0.592 to 0.749) for the prediction of treatment failure. In sensitive analyses, the predictive performances for other unfavourable outcomes were also reliable (AUC for catheter removal, 0.72, 0.62 to 0.81; for relapse or recurrence, 0.61, 0.48 to 0.74).
Conclusion
Higher levels of baseline RDW was significantly associated with greater rates of treatment failure among peritonitis episodes independent of other potential predictors.
SP492RED BLOOD CELL DISTRIBUTION WIDTH AS A PROGNOSTIC MARKER OF MORTALITY IN PATIENTS ON PERITONEAL DIALYSIS
