Red cell distribution width independently predicts cardiovascular events in patients with chronic kidney disease

Solak Y., Yilmaz M.I., Caglar K., Saglam M., Yaman H., Unal H.U., Gok M., Oguz Y., Gaipov A., Yenicesu M., Cetinkaya H., Eyileten T., Turk S., Vural A.

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Introduction and Aims: Red cell distribution width (RDW) is a measurement of size variability of the red blood cells, which easily tested during complete blood cell counts. Recent studies have shown RDWas an independent predictor of poor prognosis of cardiovascular events in patients with heart failure, prior myocardial infarction, acute coronary syndrome, coronary heart disease, peripheral arterial disease and vascular complication of diabetes. We aimed to evaluate predictive ability of RDW on prognosis of cardiovascular events in stage 1-5 chronic kidney disease (CKD) patients. Methods: 357 subjects with stage 1-5 CKD were followed for a mean of 38 (2 to 43) months. There were 71 patients with stage 1, 71 patients with stage 2, 70 patients with stage 3, 69 patients with stage 4 and 76 patients with stage 5 (predialysis) CKD. Fatal and nonfatal CV events were recorded during this period. RDW at baseline was determined from complete blood count differential. Endothelial dysfunction (flow mediated dilation, FMD), CRP and insulin resistance were determined along with routine biochemistry. We investigated if RDW could predict development of fatal and nonfatal CV events. We also looked at how RDW changed across CKD stages and whether RDW is related to insulin resistance and endothelial dysfunction. Results: 35 fatal and 88 nonfatal CV events occurred during the follow-up period. Among the fatal causes were death due to coronary heart disease (n=20), sudden death (n=4), stroke (n=8) and complicated peripheral vascular disease (n=3). Non-fatal cardiovascular events were registered as stroke (n=21), myocardial infarction (n=53), peripheral vascular disease (n=9) and aortic aneurysm (n=5). RDW showed a significant increase from stage-1 CKD to stage-5. RDW was inversely associated with FMD (r=-0.59; CI 95%; p
Original languageEnglish
Title of host publicationNephrology Dialysis Transplantation
Pagesii385
DOIs
Publication statusPublished - 2012

Publication series

NameNephrology Dialysis Transplantation
Volume27

Keywords

  • Kaplan Meier method
  • acute coronary syndrome
  • aortic aneurysm
  • arm
  • blood cell count
  • cardiovascular disease
  • cellular distribution
  • cerebrovascular accident
  • chronic kidney failure
  • death
  • diabetes mellitus
  • edetic acid
  • endothelial dysfunction
  • erythrocyte
  • evoked response audiometry
  • female
  • follow up
  • hazard ratio
  • heart failure
  • heart infarction
  • hemoglobin
  • hemoglobin blood level
  • human
  • insulin resistance
  • ischemic heart disease
  • log rank test
  • marker
  • medical history
  • patient
  • peripheral occlusive artery disease
  • peripheral vascular disease
  • prognosis
  • sudden death
  • survival rate
  • survival time
  • uremia

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    Y., S., M.I., Y., K., C., M., S., H., Y., H.U., U., M., G., Y., O., A., G., M., Y., H., C., T., E., S., T., & A., V. (2012). Red cell distribution width independently predicts cardiovascular events in patients with chronic kidney disease. In Nephrology Dialysis Transplantation (pp. ii385). (Nephrology Dialysis Transplantation; Vol. 27). https://doi.org/10.1093/ndt/gfs236