The relationship between red cell distribution width and erythropoietin resistance index in hemodialysis patients

YANG Kun; JIA Qingling; TANG Sha; WANG Weili; YUAN Fahuan; ZHANG Ying

doi:10.13431/j.cnki.immunol.j.20170076

Abstract：This study was performed to investigate the correlation between red cell distribution width (RDW) and erythropoietin resistance in maintenance hemodialysis patients.From march 2015 to march 2016,we collected 660 patients who underwent hemodialysis and recombinant human erythropoietin as treatment for more than six months in hemodialysis center of Xinqiao Hospital,then 253 patients with completed data were selected and divided into three subgroups according to the weekly doses of rhuEPO:group A (rhuEPO dose ＜150 IU·kg-1 ·week-1,n=82),group B (150 IU· kg-1· week-1 ≤ rhuEPO dose ＜300 IU· kg-1· week-1,n=137),and group C (rhuEPO dose ≥ 300 IU·kg-1· week-1,n=34) for retrospective analysis and exploring the correlationship between RDW and erythropoietin resistance index (ERI).Meanwhile 200 healthy adults were recruited as control group,and the difference of RDW between patients and control was analyzed.Rank sum test indicated that the RDW of dialysis group was significantly higher than that of the healthy control group (P＜0.05).Data also showed that there were significant differences in RDW and ERI among groups A,B and C of hemodialysis patients.Person analysis showed that ERI was negatively correlated with hemoglobin (r=-0.434,P＜0.000 1),serum iron (r=-0.168,P=0.008),while positively correlated with RDW (r=0.294,P＜0.000 1),dialysis age (r=0.180,P=0.004),In CRP (r=0.200,P=0.001).Multiple linear regression showed that hemoglobin,RDW and ERI were significantly correlated.Our result indicated that RDW is positively correlated with the resistance index,which has an important reference value for judgment of erythropoietin resistance and the clinical application of erythropoietin in hemodialysis patients.