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Renal function is independently associated with red cell distribution width in kidney transplant recipients: a potential new auxiliary parameter for the clinical evaluation of patients with chronic kidney disease
Author(s) -
Ujszaszi Akos,
Molnar Miklos Z.,
Czira Maria E.,
Novak Marta,
Mucsi Istvan
Publication year - 2013
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12315
Subject(s) - medicine , renal function , kidney disease , red blood cell distribution width , comorbidity , wasting , gastroenterology
Summary Red cell distribution width (RDW), a measure of heterogeneity in the size of circulating erythrocytes, reportedly predicts mortality. Similarly to RDW, impaired renal function is also associated with inflammation and protein‐energy wasting. This study assessed if renal function is associated with RDW independent of relevant confounders in stable kidney transplant recipients. We examined the association between RDW and estimated glomerular filtration rate ( eGFR ) in a cohort of 723 prevalent kidney transplanted recipients who were not receiving erythropoietin‐stimulating agents. Associations were examined in regression models adjusted for age, sex, comorbidity, blood haemoglobin, iron indices, markers of nutritional status and inflammation, markers of bone and mineral metabolism and the use of immune suppressants. Lower eGFR was significantly associated with higher RDW ( r = −0·382, P < 0·001). This association remained highly significant even after multivariate adjustments where 10 ml/min decrease in the eGFR was significantly associated with an increase of the RDW values ( B 10 ml/min decrease = 0·078; 95% confidence interval: 0·044–0·111). The results were consistent in subgroups of patients with different levels of haemoglobin, chronic kidney disease status and various markers of inflammation and iron status. Lower eGFR is associated with higher RDW, independent of comorbidity, iron deficiency, inflammation and nutritional status in kidney transplant recipients.