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논문분류	춘계학술대회 초록집
제목	Clinical Significance of Increase in Red Blood Cell Distribution width in Incident Dialysis Patients
저자	Hye Eun Yoon, Sung Jun Kim, Sungjin Chung, Chul Woo Yang,Yong-Soo Kim, Yoon Sik Chang, Seok Joon Shin
출판정보	2014; 2014(1):
키워드	적혈구분포폭, 투석, 심혈관질환
초록	Aim: Red cell distribution width (RDW) represents the variabililty of sizes of circulating erythrocytes. RDW is a robust marker of adverse clinical outcomes in patients with cardiovascular diseases. However the clinical significance of increase in RDW is undetermined in incident dialysis patients. Methods: Three hundred and thirty seven incident dialysis patients were included. Temporal changes in RDW during 12 months after the start of dialysis were assessed by calculating the coefficient by linear regression. Patients were divided in two groups; RDW-decreased group included those with negative coefficient values (n=184), and RDW- increased group included those with positive coefficient values (n=153). We investigated whether increase in RDW was predictive for cardiovascular events (CVE) and deaths. Results: The RDW-increased group showed significantly older age, higher serum calcium, and lower serum phosphorus and calcium-phosphorus product levels at baseline compared with the RDW-decreased group. During a median follow- up for 2.6 years (range, 0.3-7.7 years), 66 non-fatal CVE (19.6%) and 82 deaths (24.3%) occurred. The RDW- increased group showed significantly lower event-free survival rate for non-fatal CVE and deaths compared with the RDW-decreased group (p=0.009). In multivariate analysis, increase in RDW was an independent predictor for CVE and deaths (hazard ratio, 1.46; p=0.038). Conclusions: Increase in RDW independently predicted adverse outcomes in incident dialysis patients. Assessing the change in RDW after starting dialysis may be helpful to identify high risk patients for CVE or death.
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