scholarly journals Red blood cell distribution width is a predictor of chronic kidney disease progression and all-cause mortality

2021 ◽  
Vol 122 (01) ◽  
pp. 49-55
Author(s):  
F. Yilmaz ◽  
H. Sozel
2014 ◽  
Vol 111 (02) ◽  
pp. 300-307 ◽  
Author(s):  
Dahlia Weitzman ◽  
Raanan Raz ◽  
Arie Steinvil ◽  
David Zeltser ◽  
Shlomo Berliner ◽  
...  

SummaryRed blood cell distribution width (RDW) has been shown to predict cardiovascular mortality in various populations, but studies were less conclusive regarding cardiovascular morbidity. We aimed at evaluating the prognostic effect of RDW on cardiovascular morbidity and allcause mortality in the largest community cohort to date. We utilised the computerised database of a large community based healthcare maintenance organization (HMO) in Israel to identify a cohort of 225,006 eligible patients aged 40 or above who performed a blood count during 2006. We evaluated the relationship between 1% increments of RDW values and major cardiovascular events and all-cause mortality over a period of five years. A total of 21,939 incident cases of a major cardiovascular event and 4,287 deaths were documented during a total of six years of follow up, respectively. In comparison with patients with RDW level <13%, the hazard ratio for total mortality gradually increased to 4.57 (95% confidence interval [CI]: 3.35–6.24, p<0.001) among male patients and to 3.26 (95% CI: 2.49–4.28, p<0.001) among female patients with a RDW of 17% or above. Similar results were evident in anaemic and non-anaemic populations. RDW above 17% was also associated with a modest increased risk of major cardiovascular events in females 1.26 (95% CI: 1.03–1.52, p=0.021), while in men it was not significant, 1.08 (95% CI: 0.82–1.41, p=NS). In conclusion, increasing RDW levels significantly increased risk of cardiovascular morbidity and all-cause mortality. Our observation is evident in both anaemic and non-anaemic patients.


2020 ◽  
Vol 10 (3) ◽  
pp. 181-192
Author(s):  
Luís Duarte-Gamas ◽  
António Pereira-Neves ◽  
Filipa Jácome ◽  
Mariana Fragão-Marques ◽  
Ricardo P. Vaz ◽  
...  

<b><i>Objective:</i></b> Patients submitted to carotid artery endarterectomy (CEA) have a long-term risk of major adverse cardiovascular events (MACE) of 6–9% at 2 years. Hematological parameters have been shown to have a predictive function in atherosclerotic diseases, namely the red blood cell distribution width-coefficient of variation (RDW-CV). This parameter has been associated with worse outcomes such as myocardial infarction (MI), stroke, and all-cause mortality. This study aims to evaluate the potential role of preoperative hematologic parameters such as RDW-CV in predicting perioperative and long-term cardiovascular adverse events and mortality in patients submitted to CEA. <b><i>Methods:</i></b> From January 2012 to January 2019, 180 patients who underwent CEA with regional anesthesia in a tertiary care and referral center were selected from a prospective cohort database. Blood samples were collected preoperatively 2 weeks before admission, including a full blood count. The primary outcome included long-term MACE. Secondary outcomes included all-cause mortality, stroke, MI, acute heart failure, and major adverse limb events (MALE). <b><i>Results:</i></b> At baseline, 27.2% of patients had increased RDW-CV. Increased RDW-CV was independently associated with baseline hemoglobin (adjusted odds ratio [aOR] 0.715, 95% CI 0.588–0.869, <i>p</i> = 0.001) and atrial fibrillation (aOR 4.028, 95% CI 1.037–15.639, <i>p</i> = 0.001). After a median follow-up of 50 months, log-rank univariate analysis of RDW-CV demonstrated a significant association between increased RDW-CV and long-term all-cause mortality (log-rank &#x3c;0.001), MACE (log-rank &#x3c;0.001), and MI (log-rank = 0.017). After multivariate Cox regression analysis, increased RDW-CV was associated with increased long-term mortality (adjusted hazard ratio [aHR] 2.455, 95% CI 1.231–4.894, <i>p</i> = 0.011) and MACE (aHR 2.047, 95% CI 1.202–3.487, <i>p</i> = 0.008). A decreased hemoglobin to platelet ratio (aHR 2.650e–8, 95% CI 9.049e–15 to 0.078, <i>p</i> = 0.019) was also associated with all-cause mortality. <b><i>Conclusion:</i></b> RDW is a widely available and low-cost marker that independently predicts long-term mortality, MACE, and MI after CEA. This biomarker could prove useful in assessing which patients would likely benefit from CEA in the long term.


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