Aim To see whether red cell distribution width (RDW) is associated
Aim To see whether red cell distribution width (RDW) is associated with all-cause mortality in patients on chronic dialysis and to evaluate its prognostic value among validated prognostic biomarkers. intima-media thickness (IMT) (0.71 [0.47-1.25] vs 0.63 [0.31-1.55], P?=?0.011), increased NT-pro-BNP levels (8300 [1108-35000] vs 4837 [413-35000], P?=?0.043), and increased C-reactive protein (CRP) levels (11.6 [1.3-154.2] vs 4.9 [0.4-92.9], P?0.001). For each 1% point increase in RDW level as a continuous variable, one-year all cause mortality risk was increased by 54% in univariate Cox proportional hazard analysis. In the final model, when RDW was entered as a categorical variable, mortality risk was significantly increased (hazard ratio, 5.15, 95% confidence interval, 2.33 to 11.36) and patients with RDW levels above 15.75% had significantly shorter survival time (Log rank P?0.001) than others. Conclusions RDW could be an additive predictor for all-cause mortality in patients on chronic dialysis. Furthermore, RDW combined with sound clinical judgment improves identification of patients who are at increased risk compared to RDW alone. In patients on chronic dialysis, the prevalence of cardiovascular disease is very high, and among patients with chronic renal failure atherosclerosis and cardiovascular diseases are the leading cause of morbidity and mortality (1,2). Recent investigations of atherosclerosis have focused on inflammation, emphasizing the importance of endothelial dysfunction and inflammatory biomarkers interaction, suggesting that a biomarker such as C-reactive protein plays a key role in promoting atherosclerosis process and endothelial cell activation and inflammation (3,4). C-reactive protein and NT-pro-brain natriuretic peptide (NT-pro-BNP) are strong and validated prognostic biomarkers, which are considered as gold standard in patient risk assessment and survival analysis (5). Also, recent studies have identified eosinophilic cationic protein (ECP) as a biomarker of coronary atherosclerosis (6). It has been stated that ECP serum concentration is proportional to the growth of atherosclerotic plaque in the coronary vessels (6). Several studies have identified red blood cell distribution width (RDW) as a strong and independent predictor of morbidity and mortality in general population (7,8), aswell in different sets of individuals with morbidities such as for example persistent or severe center failing, cardiac arrest, pulmonary embolism, severe coronary syndrome, as well as I-CBP112 IC50 community obtained pneumonia (9-13). Furthermore, RDW continues to be identified as 3rd party brief- and long-term prognostic marker in I-CBP112 IC50 extensive care device individuals, which significantly boosts risk stratification of simplified severe physiology rating (SAPS) (14). It really is thought as a way of measuring variability in proportions of blood flow erythrocytes and offers traditionally played a job in the differential analysis of anemia (10). In everyday medical practice, it really is an assessed index instantly, which is determined by dividing regular deviation (SD) of reddish colored blood cells quantity by mean corpuscular quantity (MCV) and multiplying by 100 expressing the outcomes as percentage (10,15). Lately, it’s been proven that RDW could possibly be an additive predictor for Rabbit Polyclonal to LAT all-cause mortality in individuals with severe renal failing treated with constant renal alternative therapy (16). Nevertheless, you can find no data among individuals with chronic renal failing treated with maintenance dialysis. Consequently, we aimed to research whether RDW was connected with all-cause mortality in individuals on chronic dialysis and whether it could provide significant prognostic worth among validated prognostic biomarkers. Strategies Patients This potential longitudinal research was conducted inside a hemodialysis division of a single tertiary academic hospital with approximately 115 patients on chronic hemodialysis who were screened for participation. All patients with chronic renal failure who were treated with maintenance hemodialysis at the dialysis unit (Department for Hemodialysis, University Hospital Dubrava) between December 2010 and January 2011, and who had been on hemodialysis for at least one year, were eligible for inclusion. Exclusion criteria were I-CBP112 IC50 malignant disease, autoimmune disease, chronic immunosuppressive treatment, or recent surgical procedure. Finally in January 2011, 100 patients were included in the study cohort. I-CBP112 IC50 All included individuals underwent detailed general examination with cardiovascular priority and were given a simple questionnaire (supplementary questionnaire) (web extra material 1) for evaluation of traditional risk factors. Body-mass index.