Relation of red cell distribution width to cardiac valve calcification and carotid intima-media thickness in maintenance hemodialysis patients

Background Maintenance hemodialysis (HD) patients are at higher risk for atherosclerosis and cardiac valve calcification (CVC). Red cell distribution width (RDW) was found to be an independent predictor of cardiovascular deaths. This study aims to investigate the association between RDW and cardiovascular disease risk factors, as well as its utility as a marker for CVC and atherosclerosis in HD patients. Patients and methods A cross-sectional observational study in which demographic, anthropometric, and clinical data of 100 adult patients on HD were reported. Laboratory data included complete blood count parameters, as mean corpuscular volume, RDW-coefficient of variation (CV), and neutrophil/lymphocyte ratio, serum albumin, calculation of Kt/V, serum phosphorus, serum calcium, calcium×phosphorus product, intact parathyroid hormone, serum ferritin, C-reactive protein (CRP), and lipid profile. Echocardiography was performed to detect CVC and average common carotid intima-media thickness (CIMT) by B-mode ultrasonography. Results CVC has a positive correlation with age, HD duration, RDW-CV, CRP, and calcium×phosphorus product. While abnormal increased CIMT has a positive correlation with HD duration, RDW-CV, CRP, and aortic valve calcification, it has a negative correlation with high-density lipoprotein. RDW-CV had a significant positive correlation with HD duration and aortic valve calcification, but a significant negative correlation with high-density lipoprotein. CVC was associated with age, HD duration, RDW-CV, CRP, and Ca×Ph product in simple regression. Moreover, HD duration, RDW-CV, and CRP were good predictors for abnormal increased CIMT in multiple regression analysis. Conclusion RDW-CV is associated with CVC and abnormal increased CIMT and is a good predictor for abnormal increased CIMT in HD patients.