Red Cell Distribution Width Is Independently Related to Endothelial Dysfunction in Patients With Chronic Kidney Disease |
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| Affiliation: | From the Departments of Nephrology, Meram School of Medicine, Selcuk University, Konya, Turkey;Meram School of Medicine, Selcuk University, Konya, Turkey;Departments of Nephrology, Gulhane School of Medicine, Ankara, Turkey.;Departments of Radiology, Gulhane School of Medicine, Ankara, Turkey.;Department of Medicine, University of New Mexico, Albuquerque, New Mexico;Department of Medicine, Tufts University, Boston, Massachusetts;Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio;Department of Medicine, Boston University, Boston, Massachusetts;Dialysis Clinic, Inc, Quality Management, Albuquerque, New Mexico;National Institutes of Health, NIDDK, Bethesda, Maryland;Department of Medicine, University of New Mexico, Albuquerque, New Mexico;Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.;Department of Medicine, University of New Mexico, Albuquerque, New Mexico;Dialysis Clinic, Inc, Quality Management, Albuquerque, New Mexico;Departments of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.;Departments of Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.;Division of Nephrology, University of Texas Southwestern Medical School, Dallas, Texas.;Departments of Nephrology, McGill University, Montreal, Quebec, Canada;Departments of Pathology, McGill University, Montreal, Quebec, Canada;Departments of Cardiology, McGill University, Montreal, Quebec, Canada |
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| Abstract: | ![]()
BackgroundRed cell distribution width (RDW) is a measure of erythrocyte size variability and has been shown as an independent predictor of mortality. The aim of this article was to evaluate the association of RDW with endothelial dysfunction in patients with chronic kidney disease (CKD).MethodsPatients with 1 to 5 stages of CKD were included in the study. Endothelial function was assessed with flow-mediated dilatation (FMD). Estimated glomerular filtration rate (eGFR) and carotid intima media thickness (CIMT) were determined. Clinicode-mographic characteristics, biochemical values, complete blood counts, ferritin, C-reactive protein (CRP) and cholesterol levels were recorded. Spearman's correlation was used to determine correlates of RDW. Multivariate linear regression model was used to assess independent associates of FMD.ResultsOverall, 367 patients with CKD 1 to 5 were included in the study. RDW showed a significant increase from stage 1 to stage 5 CKD. Median RDW was 13.5. Patients with RDW values higher than median had significantly lower hemoglobin, eGFR and FMD values and higher CIMT and CRP values compared with patients who had RDW values below median. RDW showed a significant positive correlation with the presence of diabetes mellitus, CIMT and CRP, whereas a significant negative correlation with eGFR, ferritin and FMD. Multivariate analysis showed independent predictors of FMD as RDW, presence of diabetes, hemoglobin, eGFR, CRP, and serum albumin.ConclusionsMultivariate regression model revealed RDW as a significant predictor of FMD independent of major confounding factors, such as diabetes, inflammation, anemia and kidney function in CKD. |
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