The Evaluation of Red Cell Distribution Width in Chronic Hemodialysis Patients

Background. Red cell distribution width (RDW) has been used as a marker of iron deficiency; however, it is accepted as a marker of cardiovascular survival. We aimed to study RDW levels in hemodialysis (HD) patients and the association between RDW and inflammatory, nutritional, and volume markers.Methods. We included 296 HD patients with sufficient iron storage and without anemia or hypervolemia. We grouped patients into four groups according to clinical parameters, albumin, and C-reactive protein (CRP).Results. The lowest RDW levels were found in group 1 (13.2%). Although RDW of group 2 was higher than that of group 1, it was still in normal range (14.7% versus 13.2%,P=0.028). RDW levels of groups 3 (17.8%) and 4 (18.5%) were significantly higher than those of groups 1 and 2 and above normal range. A positive correlation was detected between RDW and HD duration, interdialytic weight gain (IDWG), serum phosphate, and CRP levels and a negative correlation was detected with serum albumin. HD duration, CRP, IDWG, and serum albumin have been found as independent predictors of RDW elevation.Conclusions. Results of the present study reflect adverse effects of inflammation, malnutrition, and excess IDWG on RDW elevation in an HD study cohort with sufficient iron storage and without anemia and hypervolemia.

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Red Cell Distribution Width is Associated with Future Incidence of Abdominal Aortic Aneurysm in a Population-Based Cohort Study

Scientific Reports ◽

10.1038/s41598-020-64331-7 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Jun Xiao ◽

Yan Borné ◽

Anders Gottsäter ◽

Jingxue Pan ◽

Stefan Acosta ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Population Based ◽

Red Cell Distribution Width ◽

Study Cohort ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

Abdominal Aortic ◽

Increased Risk

AbstractRed cell distribution width (RDW) has been suggested to have a predictive potential for several cardiovascular diseases, but its association with abdominal aortic aneurysm (AAA) is unknown. We examined whether RDW is associated with the risk of AAA among 27,260 individuals from the population-based Malmö Diet and Cancer Study cohort. Data of baseline characteristics were collected during 1991–1996. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for AAA across quartiles of RDW. During a median follow-up of 21.7 years, 491 subjects developed AAA. After adjustment for other confounding factors, participants in the highest quartile of RDW experienced 61% increased risk of AAA as compared to those with the lowest quartile (HR = 1.61, CI = 1.20, 2.12). RDW showed similar relationship with severe (i.e. ruptured or surgically repaired) AAA or non-severe AAA (adjusted HR 1.58 and 1.60, respectively). The observed association between RDW and AAA risk was significant in current smokers (adjusted HR = 1.68, CI = 1.18, 2.38) but not in former smokers (adjusted HR = 1.13, CI = 0.72, 1.79), or never-smokers (adjusted HR = 1.77, CI = 0.74, 4.22). Elevated RDW is associated with increased future incidence of AAA, however the causal and pathophysiological mechanisms remain to be explored.

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Red cell distribution width as a prognostic marker in septic neonates versus healthy term newborns

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20213692 ◽

2021 ◽

Vol 8 (10) ◽

pp. 1647

Author(s):

Saran Sarma ◽

Madhu George ◽

Abdul Tawab ◽

Ann Mary Zacharias

Keyword(s):

Prognostic Marker ◽

Blood Sampling ◽

Red Cell Distribution Width ◽

Control Group ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

Significant Difference ◽

And Control ◽

Group 1

Background: We evaluated the usefulness of RDW (red cell distribution width) as a diagnostic tool in newborn sepsis. Several biomarkers for sepsis have been studied including CRP (C-reactive protein), procalcitonin, interleukins, total WBC count (TC) absolute neutrophil count (ANC), ratio of immature neutrophils to total neutrophils (I/T ratio). An ideal biomarker for sepsis is still elusive. Hence we evaluated RDW as a sepsis marker as it was cheap and available. The objective of the study was to evaluate the role of RDW as a prognostic marker in newborn sepsis compared to healthy newborns.Methods: The study sample comprised of two groups (cases and control group) each with 40 neonates. Group 1 (cases group) comprised 40 newborns with suspected/probable sepsis based on clinical or laboratory parameters. In group 1 (suspected/probable sepsis) RDW was done at the time of suspicion of sepsis along with other relevant investigations. According to the clinical course these parameters were repeated 24-48 hrs after first value. Group 2 (control group) comprised 40 normal newborns in the postnatal ward. For the control group blood sampling for CBC and RDW was done simultaneously along with blood sampling for newborn screening.Results: On comparing the baseline variables there is no significant difference among cases and control group with respect to gender distribution, age in days, gestational age in weeks and birth weight. The mean RDW among the cases group was significantly higher than among the control group. In ROC analysis we obtained a cut off value of RDW of 17.25 is helpful to diagnose sepsis with reasonable sensitivity (70%) and specificity (60%).Conclusions: This study revealed that RDW may also be included in the diagnosis of sepsis in newborns as it is a simple, inexpensive, available and easily repeated test as it is routinely done with a complete blood count.

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Red Cell Distribution Width and Other Red Blood Cell Parameters in Patients with Cancer: Association with Risk of Venous Thromboembolism and Mortality

Blood ◽

10.1182/blood.v124.21.2859.2859 ◽

2014 ◽

Vol 124 (21) ◽

pp. 2859-2859 ◽

Cited By ~ 2

Author(s):

Julia Riedl ◽

Florian Posch ◽

Eva-Maria Reitter ◽

Ernst Eigenbauer ◽

Christine Marosi ◽

...

Keyword(s):

Venous Thromboembolism ◽

Cancer Patients ◽

Red Cell Distribution Width ◽

Study Cohort ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

Cumulative Survival ◽

Patients With Cancer ◽

One Year

Abstract Background: Cancer patients are at high risk of developing venous thromboembolism (VTE). However, the actual risk of VTE varies widely between individual patients and therefore in the past years several studies have focused on the identification of risk factors for cancer-associated VTE. Red cell distribution width (RDW) has been reported to be associated with arterial and venous thrombosis in non-cancer patients and with mortality in several diseases. RDW is a parameter of the complete blood count that describes the size variation of red blood cells (RBC). Here, we analyzed the association between RDW and other RBC parameters with risk of VTE and mortality in patients with cancer. Methods: RBC parameters (RDW, hematocrit, hemoglobin concentration, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration) were measured in 1840 patients with cancers of the lung (=309), breast (n=273), brain (n=245), colon/rectum (n=182), prostate (n=157), pancreas (n=130), stomach (=63), kidney (n=42); lymphoma (n=260), multiple myeloma (n=49) and other tumor sites (n=130) that were included in the Vienna Cancer and Thrombosis Study (CATS). CATS is an ongoing prospective, observational cohort study of patients with newly diagnosed or progressive cancer after remission. Primary study outcome is occurrence of symptomatic VTE and secondary outcome is death during a maximum follow-up period of 2 years. Results: During a median follow-up of 706 days, 131 (7.1%) patients developed VTE and 702 (38.2%) died. High RDW (>16%) was not associated with a higher risk of VTE in the total study cohort; in competing risk analysis accounting for death as competing variable the univariable subhazard ratio (SHR) was 1.34 (95% confidence interval [CI]: 0.80-2.23, p=0.269). In patients with high RDW (>16%), the cumulative probability of VTE was 7.5% after 6 months, 8.7% after one year and 9.3% after two years in comparison to a probability of 5.0% after 6 months, 6.2% after one year and 7.2% after two years in those patients who had a lower RDW (Gray's test p=0.267; Figure 1). There was also no significant association between other RBC parameters and risk of VTE. In subgroup analysis of patients with solid tumors only, high RDW (>16%) was associated with an 80% increase in risk of VTE compared to lower RDW (SHR [95% CI]: 1.80 [0.99-3.26], p=0.053). However, in multivariable analyses adjusting for age, sex, hemoglobin, leukocyte and platelet count we did not observe a significant association between RDW and risk of VTE (SHR [95% CI]: 1.57 [0.81-3.04], p=0.182). High RDW was associated with an increased risk of mortality in the total study population (hazard ratio [HR, 95% CI]: 1.72 [1.39-2.12], p<0.001), and this association prevailed after adjustment for age, sex, hemoglobin, leukocyte and platelet count (HR [95% CI]: 1.34 [1.06-1.70], p=0.016). The cumulative probability of survival in patients with high RDW (>16%) was 78.5% after 6 months, 66.2% after one year and 41.3% after two years. In comparison, patients with non-elevated RDW levels had a cumulative survival probability of 88.7% after 6 months, 75.1% after one year and 66.2% after two years (Log-rank p<0.001; Figure 2). Conclusions: RDW and other RBC parameters were not independently associated with risk of VTE in patients with cancer and might therefore not be of added value for estimating risk of VTE in patients with cancer. We could confirm that high RDW is an independent predictor of poor overall survival in cancer. Figure 1. Cumulative incidence of venous thromboembolism (VTE), accounting for competing risk (death of any cause) in the total study cohort, grouped into patients with red cell distribution width (RDW) >16% and below, respectively. Figure 1. Cumulative incidence of venous thromboembolism (VTE), accounting for competing risk (death of any cause) in the total study cohort, grouped into patients with red cell distribution width (RDW) >16% and below, respectively. Figure 2. Kaplan-Meier estimates for cumulative survival probability of cancer patients (total study cohort) with red blood cell distribution width (RDW) >16% and below, respectively. Figure 2. Kaplan-Meier estimates for cumulative survival probability of cancer patients (total study cohort) with red blood cell distribution width (RDW) >16% and below, respectively. Disclosures No relevant conflicts of interest to declare.

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Preoperative red cell distribution width and neutrophil-to-lymphocyte ratio predict survival in patients with epithelial ovarian cancer

10.26226/morressier.5770e29dd462b80290b4be83 ◽

2016 ◽

Author(s):

Zheng Li

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Neutrophil To Lymphocyte Ratio ◽

Red Cell Distribution Width ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

Lymphocyte Ratio

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Faculty Opinions recommendation of A retrospective cohort study on the association between elevated preoperative red cell distribution width and all-cause mortality after noncardiac surgery.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.737641408.793575041 ◽

2020 ◽

Author(s):

Yuguang Huang ◽

Xiaohan Xu

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Noncardiac Surgery ◽

Red Cell Distribution Width ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

All Cause Mortality

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Prognostic Value of the Hemoglobin/Red Cell Distribution Width Ratio in Resected Lung Adenocarcinoma

Cancers ◽

10.3390/cancers13040710 ◽

2021 ◽

Vol 13 (4) ◽

pp. 710

Author(s):

Francesco Petrella ◽

Monica Casiraghi ◽

Davide Radice ◽

Andrea Cara ◽

Gabriele Maffeis ◽

...

Keyword(s):

Prognostic Factor ◽

Lung Adenocarcinoma ◽

Disease Free Survival ◽

Red Cell Distribution Width ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

Free Survival ◽

Node Involvement ◽

Disease Free

Background: The ratio of hemoglobin to red cell distribution width (HRR) has been described as an effective prognostic factor in several types of cancer. The aim of this study was to investigate the prognostic role of preoperative HRR in resected-lung-adenocarcinoma patients. Methods: We enrolled 342 consecutive patients. Age, sex, surgical resection, adjuvant treatments, pathological stage, preoperative hemoglobin, red cell distribution width, and their ratio were recorded for each patient. Results: Mean age was 66 years (SD: 9.0). There were 163 females (47.1%); 169 patients (49.4%) had tumors at stage I, 71 (20.8%) at stage II, and 102 (29.8%) at stage III. In total, 318 patients (93.0%) underwent lobectomy, and 24 (7.0%) pneumonectomy. Disease-free survival multivariable analysis disclosed an increased hazard ratio (HR) of relapse for preoperative HRR lower than 1.01 (HR = 2.20, 95%CI: (1.30–3.72), p = 0.004), as well as for N1 single-node (HR = 2.55, 95%CI: (1.33–4.90), p = 0.005) and multiple-level lymph node involvement compared to N0 for both N1 (HR = 9.16, 95%CI:(3.65–23.0), p < 0.001) and N2 (HR = 10.5, 95%CI:(3.44–32.2, p < 0.001). Conclusion: Pre-operative HRR is an effective prognostic factor of disease-free survival in resected-lung-adenocarcinoma patients, together with the level of pathologic node involvement.

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