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Red cell distribution width is associated with mortality in kidney transplant recipients

  • Nephrology - Original Paper
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Abstract

Background

Red cell distribution width (RDW), a parameter routinely reported as part of the complete blood count, is associated with increased morbidity and mortality risk in different patient populations. No published data are available about the association between RDW and mortality in kidney transplant recipients.

Methods

We collected socio-demographic, clinical parameters, medical and transplant history and laboratory data at baseline in 723 prevalent kidney transplant recipients between June and October 2008 [mean age 51 ± 13 (SD) years, 56 % men, 21 % diabetics]. Associations between baseline RDW values and all-cause mortality over 3 years were examined in unadjusted and adjusted models.

Results

Increasing RDW was associated with increased mortality in both unadjusted [(HR1 % increase = 1.63; 95 % CI 1.41–1.89) and (HR>median = 2.74; 95 % CI 1.68–4.48)] and fully adjusted models [(HR1 % increase = 1.60; 95 % CI 1.27–1.89) and (HR>median = 1.33; 95 % CI 0.76–2.35)]. In reclassification analyses, RDW improved the predictive value of all-cause mortality prediction models [the net reclassification improvement (NRI) was 0.189; p < 0.001].

Conclusions

RDW, a cheap and readily available but largely neglected parameter independently, predicts mortality in prevalent kidney transplant recipients and could potentially been used in everyday risk assessment of kidney transplant recipients.

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Acknowledgments

The authors thank the patients and the staff in the Department of Transplantation and Surgery, Semmelweis University, Budapest. This study was supported by grants from the Hungarian Kidney Foundation, Hungarian Society of Hypertension, Hungarian Society of Nephrology and the Foundation for Prevention in Medicine. MZ. Molnar is recipient of the Hungarian Eötvös Scholarship (MÖB/77-2/2012). A. Ujszaszi is recipient of the Hungarian Eötvös Scholarship (MÖB/77-3/2012).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Institute of Pathophysiology, Semmelweis University, Budapest, Hungary

    Istvan Mucsi & Akos Ujszaszi

  2. Division of Nephrology, Department of Medicine, McGill University Health Centre, Royal Victoria Hospital, 687 Pine Avenue West, Room R2.37, Montreal, QC, H3A 1A1, Canada

    Istvan Mucsi

  3. Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary

    Istvan Mucsi, Maria E. Czira & Marta Novak

  4. Harold Simmons Center for Chronic Disease Research and Epidemiology, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA

    Akos Ujszaszi & Miklos Z. Molnar

  5. Department of Psychiatry, University Health Network, University of Toronto, Toronto, Canada

    Marta Novak

  6. Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada

    Miklos Z. Molnar

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  1. Istvan Mucsi
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  2. Akos Ujszaszi
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  3. Maria E. Czira
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  5. Miklos Z. Molnar
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Correspondence to Istvan Mucsi.

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Mucsi, I., Ujszaszi, A., Czira, M.E. et al. Red cell distribution width is associated with mortality in kidney transplant recipients. Int Urol Nephrol 46, 641–651 (2014). https://doi.org/10.1007/s11255-013-0530-z

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