AUSTIN, Texas—Patients whose red blood cell distribution width (RDW) increased over the first year of hemodialysis (HD) had worse survival than those whose RDW decreased or stayed the same, researchers reported at the National Kidney Foundation meeting.

Kamyar Kalantar-Zadeh, MD, PhD, of the University of California Irvine School of Medicine, and colleagues analyzed RDW, a measure of variability in erythrocyte size, over the first 5 quarters of HD for 62,546 patients from a US-based dialysis organization. RDW displayed an inverse linear relationship with all-cause mortality in all models. The team adjusted for case-mix, comorbidities, markers of malnutrition and inflammation, medications, and imbalanced covariates. HD patients with a change in RDW above 0% had a 28% higher risk for mortality, compared with those with a change in RDW of 0% to -1%.

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“Further studies should examine the utility of RDW as a predictive marker of mortality in hemodialysis patients and the underlying pathophysiology of this relationship,” Dr Kalantar-Zadeh and the team concluded.

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Edgett D, Streja E, Park C, Soohoo M, Molnar MZ,  Kovesdy CP, and Kalantar-Zadeh K. First year change in red blood cell distribution width and its association with all-cause mortality in hemodialysis patients. Data presented in poster format at the National Kidney Foundation’s 2018 Spring Clinical Meetings in Austin, Texas, April 10–14. Poster 151.