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Progressive Rise in Red Blood Cell Distribution Width Predicts Mortality and Cardiovascular Events in End-Stage Renal Disease Patients
Red blood cell distribution width (RDW) is a robust marker of adverse clinical outcomes in various populations. However, the clinical significance of a progressive rise in RDW is undetermined in end-stage renal disease (ESRD) patients. The purpose of this study was to determine the prognostic import...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4427112/ https://www.ncbi.nlm.nih.gov/pubmed/25961836 http://dx.doi.org/10.1371/journal.pone.0126272 |
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author | Yoon, Hye Eun Kim, Sung Jun Hwang, Hyeon Seok Chung, Sungjin Yang, Chul Woo Shin, Seok Joon |
author_facet | Yoon, Hye Eun Kim, Sung Jun Hwang, Hyeon Seok Chung, Sungjin Yang, Chul Woo Shin, Seok Joon |
author_sort | Yoon, Hye Eun |
collection | PubMed |
description | Red blood cell distribution width (RDW) is a robust marker of adverse clinical outcomes in various populations. However, the clinical significance of a progressive rise in RDW is undetermined in end-stage renal disease (ESRD) patients. The purpose of this study was to determine the prognostic importance of a change in RDW in ESRD patients. Three hundred twenty-six incident dialysis patients were retrospectively analyzed. Temporal changes in RDW during 12 months after dialysis initiation were assessed by calculating the coefficients by linear regression. Patients were divided into two groups: an RDW-decreased group who had negative coefficient values (n = 177) and an RDW-increased group who had positive values (n = 149). The associations between rising RDW and mortality and cardiovascular (CV) events were investigated. During a median follow-up of 2.7 years (range, 1.0–7.7 years), 75 deaths (24.0%) and 60 non-fatal CV events (18.4%) occurred. The event-free survival rate for the composite of end-points was lower in the RDW-increased group (P = 0.004). After categorizing patients according to baseline RDW, the event-free survival rate was lowest in patients with a baseline RDW >14.9% and increased RDW, and highest in patients with a baseline RDW ≤14.9% and decreased RDW (P = 0.02). In multivariate analysis, rising RDW was independently associated with the composite of end-points (hazard ratio = 1.75, P = 0.007), whereas the baseline RDW was not. This study shows that a progressive rise in RDW independently predicted mortality and CV events in ESRD patients. Rising RDW could be an additive predictor for adverse CV outcomes ESRD patients. |
format | Online Article Text |
id | pubmed-4427112 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-44271122015-05-21 Progressive Rise in Red Blood Cell Distribution Width Predicts Mortality and Cardiovascular Events in End-Stage Renal Disease Patients Yoon, Hye Eun Kim, Sung Jun Hwang, Hyeon Seok Chung, Sungjin Yang, Chul Woo Shin, Seok Joon PLoS One Research Article Red blood cell distribution width (RDW) is a robust marker of adverse clinical outcomes in various populations. However, the clinical significance of a progressive rise in RDW is undetermined in end-stage renal disease (ESRD) patients. The purpose of this study was to determine the prognostic importance of a change in RDW in ESRD patients. Three hundred twenty-six incident dialysis patients were retrospectively analyzed. Temporal changes in RDW during 12 months after dialysis initiation were assessed by calculating the coefficients by linear regression. Patients were divided into two groups: an RDW-decreased group who had negative coefficient values (n = 177) and an RDW-increased group who had positive values (n = 149). The associations between rising RDW and mortality and cardiovascular (CV) events were investigated. During a median follow-up of 2.7 years (range, 1.0–7.7 years), 75 deaths (24.0%) and 60 non-fatal CV events (18.4%) occurred. The event-free survival rate for the composite of end-points was lower in the RDW-increased group (P = 0.004). After categorizing patients according to baseline RDW, the event-free survival rate was lowest in patients with a baseline RDW >14.9% and increased RDW, and highest in patients with a baseline RDW ≤14.9% and decreased RDW (P = 0.02). In multivariate analysis, rising RDW was independently associated with the composite of end-points (hazard ratio = 1.75, P = 0.007), whereas the baseline RDW was not. This study shows that a progressive rise in RDW independently predicted mortality and CV events in ESRD patients. Rising RDW could be an additive predictor for adverse CV outcomes ESRD patients. Public Library of Science 2015-05-11 /pmc/articles/PMC4427112/ /pubmed/25961836 http://dx.doi.org/10.1371/journal.pone.0126272 Text en © 2015 Yoon et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Yoon, Hye Eun Kim, Sung Jun Hwang, Hyeon Seok Chung, Sungjin Yang, Chul Woo Shin, Seok Joon Progressive Rise in Red Blood Cell Distribution Width Predicts Mortality and Cardiovascular Events in End-Stage Renal Disease Patients |
title | Progressive Rise in Red Blood Cell Distribution Width Predicts Mortality and Cardiovascular Events in End-Stage Renal Disease Patients |
title_full | Progressive Rise in Red Blood Cell Distribution Width Predicts Mortality and Cardiovascular Events in End-Stage Renal Disease Patients |
title_fullStr | Progressive Rise in Red Blood Cell Distribution Width Predicts Mortality and Cardiovascular Events in End-Stage Renal Disease Patients |
title_full_unstemmed | Progressive Rise in Red Blood Cell Distribution Width Predicts Mortality and Cardiovascular Events in End-Stage Renal Disease Patients |
title_short | Progressive Rise in Red Blood Cell Distribution Width Predicts Mortality and Cardiovascular Events in End-Stage Renal Disease Patients |
title_sort | progressive rise in red blood cell distribution width predicts mortality and cardiovascular events in end-stage renal disease patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4427112/ https://www.ncbi.nlm.nih.gov/pubmed/25961836 http://dx.doi.org/10.1371/journal.pone.0126272 |
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