The Prognostic Value of Red Blood Cell Distribution Width in Patients on Maintenance Hemodialysis

Abstract

Aims: To examine the association between red blood cell distribution width (RDW) and mortality in hemodialysis (HD) patients.

Methods: Three hundred fifty six patients on HD for >3 months were enrolled and followed for 2 years. Patients were divided into 2 groups according to the median RDW value. Patient survival and risk factors for mortality were investigated.

Results: The 2-year survival rate was significantly lower in the high-RDW group (>14.9%; log-rank = 10.00, p = 0.0016). RDW (hazard ratio (HR) 1.34, 95% CI 1.04-1.71, p = 0.021), hemoglobin (HR 0.98, 95% CI 0.96-1.00, p = 0.023) and albumin (HR 0.90, 95% CI 0.82-0.99, p = 0.026) were independent predictors of mortality. Receiver operating characteristic curves of RDW to predict 2-year mortality had an area under the curve of 0.6487 (95% CI 0.5714-0.7260).

Conclusions: Abnormal RDW was common in HD patients and significantly related with poor outcomes in these patients.