Red cell distribution width associated with adverse cardiovascular outcomes in patients with chronic kidney disease

Yueh An Lu, Pei Chun Fan, Cheng Chia Lee, Victor Chien Chia Wu, Ya Chung Tian, Chih Wei Yang, Yung Chang Chen, Chih Hsiang Chang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

18 Scopus citations


Background: Recent studies have demonstrated that red cell distribution width (RDW) is associated with cardiovascular (CV) events and mortality. Patients with chronic kidney disease (CKD) are often anemic and have high RDW levels. In this study, we investigated the effect of RDW on major composite CV outcomes among patients with CKD. Methods: We retrospectively analyzed patients with CKD who were admitted to the department of cardiology of a tertiary hospital in 2011. The patients were divided into 2 groups: normal RDW (RDW < 14.5%) and elevated RDW (RDW ≥ 14.5%). Demographic characteristics, comorbidities, blood investigation results, prescriptions, and outcomes were analyzed after a 3-year follow-up period. Six adjustment levels were performed to evaluate the effect of RDW on outcomes. Results: This study involved 282 patients with CKD: 213 in the elevated RDW group and 69 in the normal RDW group. The elevated RDW group had older patients, a lower proportion of male patients, lower left ventricular ejection fraction (LVEF) values, lower hemoglobin levels, lower serum albumin levels, and higher creatinine levels, compared with the normal RDW group. A linear trend was observed toward higher RDW in patients with deteriorating renal function. In the final adjusted model, RDW ≥ 14.5%, older age, and lower LVEF were associated with an increased risk of major composite CV outcomes. Conclusion: RDW is a potentially useful cost-effective indicator of major composite CV outcomes in patients with CKD.

Original languageEnglish
Article number361
JournalBMC Nephrology
Issue number1
StatePublished - 13 12 2017

Bibliographical note

Publisher Copyright:
© 2017 The Author(s).


  • Cardiovascular outcomes
  • Chronic kidney disease
  • Red cell distribution width


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