Study Of Red Blood Cell Distribution Width And Cardiovascular Disease Events In Peritoneal Dialysis Patients

Objective:To analysis the relation and predictive value between red blood cell distribution width(RDW)and cardiovascular disease(CVD)events in peritoneal dialysis(PD)patients,and provide theoretical basis for clinical intervention.Methods:The clinical data of 203 PD patients who were followed up regularly from The First Hospital of Shanxi Medical University from January 2013 to May 2018 were retrospectively analyzed.The patients were divided into low RDW group(RDW<15.0%,n=114)and high RDW group(RDW≥15.0%,n=89)by RDW normal reference value.The general data,clinical indexes and incidence of CVD events were compared between the two groups.Spearman correlation analysis was used to analyze the correlation between RDW and each index.The survival curve was drawn by Kaplan-Meier method and the incidence of CVD events was compared by Log-Rank method.Multivariate Cox regression was used to analyze risk factors for CVD events.Results:1.A total of 63 patients had CVD events,and the incidence of CVD events was31.0%.Patients with high RDW group(37 cases)had higher CVD events than those with low RDW group(26 cases)(?~2=8.224,P=0.004).The age of both groups(t=3.758,P<0.001),previous CVD history(?~2=8.004,P=0.005)was statistically significant.2.Between the two groups,CRP(t=3.395,P=0.001),Hb(t=-3.281,P=0.001),ALB(t=-2.687,P=0.008),PA(t=-3.369,P=0.001),Fe(t=-2.367,P=0.019),TSAT(t=-2.928,P=0.004),24h urine volume(t=-3.055,P=0.003),eGFR(t=-2.706,P=0.007)was statistically significant.3.RDW was positively correlated with age(r=0.761,P=0.002),CRP(r=0.712,P=0.014),previous CVD history(r=0.438,P<0.001),and Hb(r=-0.697,P=0.019),ALB(r=-0.692,P=0.008),PA(r=-0.747,P=0.007),Fe(r=-0.705,P=0.013),TSAT(r=-0.685,P=0.021),eGFR(r=-0.639,P=0.023)showed a negative correlation.4.Heart failure was the most common in CVD events,accounting for 41.3%of CVD events,Kaplan-Meier survival curve showed that the incidence of CVD events was significantly higher in the high RDW group than in the low RDW group(Log-Rank test?~2=11.428,P=0.001).5.Multivariate Cox regression analysis showed RDW(RR 2.095,95%CI1.714-2.561,P<0.001),age(RR1.629,95%CI1.454-1.826,P<0.001),previous cardiovascular history(RR 1.699,95%CI 1.296-2.226,P<0.001)were independent risk factors for CVD events in PD patients.Conclusion:The increased level of RDW was an independent risk factor for CVD events in PD patients,and may have predictive value for the occurrence of CVD events in PD patients.