Red Cell Distribution Width as a Severity Marker on the Outcome of Patients with Acute Kidney Injury on Renal Replacement Therapy

BACKGROUND: Acute kidney injury (AKI) requiring dialysis is associated with high mortality and morbidity. Red blood cell distribution width (RDW) has been shown as a predictor of mortality in different subsets of patients admitted to intensive care unit (ICU). This study compares the predictive ability of RDW and other severity illness prognostic models on 30 days mortality in adult patients admitted to ICUs with AKI necessitating dialysis. MATERIALS AND METHODS: Thirty patients were evaluated using five different prognostic scoring models. Sequential organ failure assessment (SOFA) score, acute tubular necrosis-individual severity index (ATN-ISI), version II of acute physiology and chronic health evaluation (APACHE II), vasoactive-inotropic score (VIS), version II of simplified acute physiology score (SAPS II), and RDW as a marker were used to prognosticate the severity of illness. The scores were calculated using the values of clinical and laboratory parameters at the time of admission. RESULTS: The prognostic abilities of the scores were compared for their discriminatory power using receiver-operating characteristic (ROC) curves. The area under the ROC curve (AROC) of RDW was 0.904, SOFA score was 0.828, ATN-ISI was 0.743, SAPS was 0.857, and APACHE II score was 0.828. Vasoactive-inotropic score has the lowest discriminatory power with AROC of 0.487. Red blood cell distribution width has a strong and significant correlation with APACHE II and SOFA scores and a weak relation with ATN-ISI score and SAPS II. CONCLUSION: Red blood cell distribution width has a better predictive ability than other disease severity scoring systems to predict mortality in an adult AKI patient admitted to ICU with need for renal replacement therapy (RRT). HOW TO CITE THIS ARTICLE: Nanjarapalle S, Samantaray A, Vishnubhotla S. Red Cell Distribution Width as a Severity Marker on the Outcome of Patients with Acute Kidney Injury on Renal Replacement Therapy. Indian J Crit Care Med 2020;24(2):95–98.