红细胞分布宽度在慢性肾脏病中的应用进展
Progress in the Application of Red Blood Cell Distribution Width in Chronic Kidney Disease
摘要: 红细胞分布宽度(red cell distribution width, RDW)是全血常规中一项重要的检测指标,既往常与平均红细胞体积(mean red blood cell volume, MCV)相结合来诊断患者贫血的类型,但有研究发现RDW可预测普通人群的死亡风险,并且在心血管疾病、恶性肿瘤、糖尿病、肾脏相关疾病、乙肝、非酒精性脂肪肝、活动性的类风湿关节炎、胆道狭窄、脓毒症、新生儿疾病及慢性阻塞性肺疾病等多种疾病中具有一定的临床意义。该文将重点对RDW在慢性肾脏病(chronic kidney disease, CKD)中的应用进展及相关机制进行综述。
Abstract: Red cell distribution width (RDW) is an important test index in whole blood routine. It is usually combined with mean red blood cell volume (MCV) to diagnose the type of anemia in patients. However, some studies have found that RDW can predict the risk of death in the general population. And in cardiovascular diseases, malignant tumors, diabetes, kidney related diseases, hepatitis B, non-alcoholic fatty liver disease, active rheumatoid arthritis, biliary tract stenosis, sepsis, neonatal diseases and chronic obstructive pulmonary disease and other diseases have a certain clinical significance. In this paper, the application of RDW in chronic kidney disease (CKD) and its related mechanisms will be reviewed.
文章引用:马玉, 张小丽, 高爱民. 红细胞分布宽度在慢性肾脏病中的应用进展[J]. 临床医学进展, 2021, 11(4): 1755-1761. https://doi.org/10.12677/ACM.2021.114252

参考文献

[1] 曾颖. 红细胞分布宽度在维持性血液透析患者中的相关因素分析及其对预后评估研究[D]: [博士学位论文]. 苏州: 苏州大学, 2018.
[2] Docci, D., Delvecchio, C., Gollini, C., Turci, F., Baldrati, L. and Gilli, P. (1989) Red Blood Cell Volume Distribution Width (RDW) in Uraemic Patients on Chronic Haemodialysis. The International Journal of Artificial Organs, 12, 170-174. [Google Scholar] [CrossRef] [PubMed]
[3] Lippi, G., Targher, G., Montagnana, M., Luca Salvagno, G., Zoppini, G. and Guidi, G.C. (2008) Relationship between Red Blood Cell Distribution Width and Kidney Function Tests in a Large Cohort of Unselected Outpatients. Scandinavian Journal of Clinical and Laboratory Investigation, 68, 745-748. [Google Scholar] [CrossRef] [PubMed]
[4] Yilmaz, F. and Sozel, H. (2021) Red Blood Cell Distribution Width Is a Predictor of Chronic Kidney Disease Progression and All-Cause Mortality. Bratislava Medical Journal, 122, 49-55. [Google Scholar] [CrossRef
[5] Sičaja, M., Pehar, M., Đerek, L., Starčević, B., Vuletić, V., Romić, Ž., et al. (2013) Red Blood Cell Distribution Width as a Prognostic Marker of Mortality in Patients on Chronic Dialysis: A Single Center, Prospective Longitudinal Study. Croatian Medical Journal, 54, 25-32. [Google Scholar] [CrossRef] [PubMed]
[6] Yoon, H.E., Kim, S.J., Hwang, H.S., Chung, S., Yang, C.W. and Shin, S.J. (2015) Progressive Rise in Red Blood Cell Distribution Width Predicts Mortality and Cardiovascular Events in End-Stage Renal Disease Patients. PLoS ONE, 10, e0126272. [Google Scholar] [CrossRef] [PubMed]
[7] Yeh, H.C., Lin, Y.T., Ting, I.W., Huang, H.-C., Chiang, H.-Y., Chung, C.-W., et al. (2019) Variability of Red Blood Cell Size Predicts All-CAUSE mortality, But Not Progression to Dialysis, in Patients with Chronic Kidney Disease: A 13-Year Pre-ESRD Registry-Based Cohort. Clinica Chimica Acta, 497, 163-171. [Google Scholar] [CrossRef] [PubMed]
[8] Chen, X, Shen, B., Zou, J., Liu, Z., Lv, W., Cao, X., et al. (2016) The Prognostic Value of Red Blood Cell Distribution Width in Patients on Maintenance Hemodialysis. Blood Purification, 42, 314-321. [Google Scholar] [CrossRef] [PubMed]
[9] Vashistha, T., Streja, E., Molnar, M.Z., Rhee, C.M., Moradi, H., Soohoo, M., et al. (2016) Red Cell Distribution Width and Mortality in Hemodialysis Patients. American Journal of Kidney Diseases, 68, 110-121. [Google Scholar] [CrossRef] [PubMed]
[10] Hsieh, Y.P., Chang, C.C., Kor, C.T., Yang, Y., Wen, Y.-K. and Chiu, P.-F. (2016) The Predictive Role of Red Cell Distribution Width in Mortality among Chronic Kidney Disease Patients. PLoS ONE, 11, e0162025. [Google Scholar] [CrossRef] [PubMed]
[11] 侯凡凡, 马志刚, 梅长林, 戎殳, 黄颂敏, 刘先蓉, 等. 中国五省市自治区慢性肾脏病患者心血管疾病的患病率调查[J]. 中华医学杂志, 2005, 85(7): 458-463.
[12] Fukasawa, H., Ishibuchi, K., Kaneko, M., Niwa, H., Yasuda, H., Kumagai, H., et al. (2017) Red Blood Cell Distribution Width Is Associated with All-Cause and Cardiovascular Mortality in Hemodialysis Patients. Therapeutic Apheresis and Dialysis, 21, 565-571. [Google Scholar] [CrossRef] [PubMed]
[13] 张梅, 孙晓媚, 岳英, 姜立萍. 红细胞体积分布宽度对维持性血液透析患者心血管事件预测作用[J]. 中国临床保健杂志, 2020, 23(4): 469-473.
[14] GBD Chronic Kidney Disease Collaboration (2020) Global, Regional, and National Burden of Chronic Kidney Disease, 1990-2017: A Systematic Analysis for the Global Burden of Disease Study 2017. Lancet, 395, 709-733. [Google Scholar] [CrossRef
[15] Tanaka, K., Watanabe, T., Takeuchi, A., Ohashi, Y., Nitta, K., Akizawa, T., et al. (2017) Cardiovascular Events and Death in Japanese Patients with Chronic Kidney Disease. Kidney International, 91, 227-234. [Google Scholar] [CrossRef] [PubMed]
[16] Solak, Y., Yilmaz, M.I., Saglam, M., Kayrak, M., Yilmaz, M.I., Caglar, K., et al. (2014) Red Cell Distribution Width Is Independently Related to Endothelial Dysfunction in Patients with Chronic Kidney Disease. American Journal of the Medical Sciences, 347, 118-124. [Google Scholar] [CrossRef
[17] Peng, F., Li, Z., Zhong, Z., Luo, Q., Guo, Q., Huang, F., et al. (2014) An Increasing of Red Blood Cell Distribution Width Was Associated with Cardiovascular Mortality in Patients on Peritoneal Dialysis. International Journal of Cardiology, 176, 1379-1381. [Google Scholar] [CrossRef] [PubMed]
[18] 毛长青, 王蕾, 金惠良, 李峰, 陈腾飞, 高秋凤, 等. 老年血液透析患者红细胞体积分布宽度水平及相关影响因素分析[J]. 中国临床医学, 2019, 26(4): 532-537.
[19] 张洪旭. 红细胞分布宽度对维持性血液透析患者相关因素影响研究[C]//中国中西医结合学会肾脏疾病专业委员会. 中国中西医结合学会肾脏疾病专业委员会2018年学术年会论文摘要汇编. 北京: 中国中西医结合学会, 2018: 1.
[20] 苏爽. 维持性血液透析患者红细胞体积分布宽度与相关影响因素分析[J]. 临床合理用药杂志, 2018, 11(5): 102-103.
[21] 梁慧敏, 王聪, 解心悦, 李海燕, 戴厚永, 袁莉. 血液透析患者红细胞分布宽度及相关因素分析[J]. 交通医学, 2018, 32(1): 23-25+28.
[22] 沈波, 刘中华, 邹建洲, 徐少伟, 徐磊, 潘文志, 等. 维持性血液透析患者红细胞体积分布宽度及相关影响因素研究[J]. 中国临床医学, 2012, 19(5): 496-499.
[23] Li, J., Yang, X., Ma, J., Gong, F. and Chen, Q. (2018) Relationship of Red Blood Cell Distribution Width with Cancer Mortality in Hospital. BioMed Research International, 2018, Article ID: 8914617. [Google Scholar] [CrossRef] [PubMed]
[24] Allen, L.A., Felker, G.M., Mehra, M.R., Chiong, J.R., Dunlap, S.H., Ghali, J.K., et al. (2010) Validation and Potential Mechanisms of Red Cell Distribution Width as a Prognostic marker in Heart Failure. Journal of Cardiac Failure, 16, 230-238. [Google Scholar] [CrossRef] [PubMed]
[25] Förhécz, Z., Gombos, T., Borgulya, G., Pozsonyi, Z., Prohászka, Z. and Jánoskuti, L. (2009) Red cell distribution width in heart failure: prediction of clinical Events and Relationship with Markers of Ineffective Erythropoiesis, Inflammation, Renal Function, and Nutritional State. American Heart Journal, 158, 659-666. [Google Scholar] [CrossRef] [PubMed]
[26] 付永奇, 田祥, 李放, 王伟. 红细胞分布宽度在心血管疾病中作用的研究进展[J]. 河北医药, 2015, 37(5): 729-731.
[27] Veeranna, V., Zalawadiya, S.K., Panaich, S.S., Ramesh, K. and Afonso, L. (2012) The Association of Red Cell Distribution Width with Glycated Hemoglobin among Healthy Adults without Diabetes Mellitus. Cardiology, 122, 129-132. [Google Scholar] [CrossRef] [PubMed]
[28] 贾凯剑, 郭任维, 李莉. 红细胞分布宽度在心力衰竭中应用的研究进展[J]. 中国医学创新, 2019, 16(7): 165-168.
[29] Tozzi-Ciancarelli, M.G., Di Giulio, A., Troiani-Sevi, E., D’Alfonso, A., Amicosante, G. and Oratore, A. (1989) Human Erythrocyte Damage at the Initial Stages of Oxidative Stress. Cell Biophysics, 15, 225-234. [Google Scholar] [CrossRef
[30] Semba, R.D., Patel, K.V., Ferrucci, L., Sun, K., Roy, C.N., Guralnik, J.M., et al. (2010) Serum Antioxidants and Inflammation Predict Red Cell Distribution Width in Older Women: The Women’s Health and Aging Study I. Clinical Nutrition, 29, 600-604. [Google Scholar] [CrossRef] [PubMed]
[31] Kobayashi, S., Moriya, H., Aso, K. and Ohtake, T. (2003) Vitamin E-Bonded Hemodialyzer Improves Atherosclerosis Associated with a Rheological Improvement of Circulating Red Blood Cells. Kidney International, 63, 1881-1887. [Google Scholar] [CrossRef] [PubMed]
[32] Yilmaz, Z., Yildirim, Y., Oto, F., Yilmaz Aydin, F., Aydin, E., Kemal Kadiroglu, A., et al. (2014) Evaluation of Volume Overload by Bioelectrical impedance Analysis, NT-proBNP and Inferior Vena Cava Diameter in Patients with Stage 3&4 and 5 Chronic Kidney Disease. Renal Failure, 36, 495-501. [Google Scholar] [CrossRef
[33] 黄超越, 耿蕾, 温向琼, 高利超, 甘林望, 刘建. 红细胞分布宽度对老年维持性血液透析患者预后的预测价值[J]. 海南医学院学报, 2019, 25(21): 1641-1645.
[34] 张洋, 康金锁, 于金星, 张春玲, 袁新民, 陈曦, 等. 红细胞体积分布宽度与心衰患者血浆N末端脑钠肽关系的研究[J]. 中国实验诊断学, 2011, 15(6): 1017-1019.
[35] Yildiz, A., Oflaz, H., Pusuroglu, H., Mercanoglu, F., Genchallac, H., Akkaya, V., et al. (2003) Left Ventricular Hypertrophy and Endothelial Dysfunction in Chronic Hemodialysis Patients. American Journal of Kidney Diseases, 41, 616-623. [Google Scholar] [CrossRef] [PubMed]
[36] Patel, K.V., Mohanty, J.G., Kanapuru, B., Hesdorffer, C., Ershler, W.B. and Rifkind, J.M. (2013) Association of the Red Cell Distribution Width with Red Blood Cell Deformability. In: Welch, W.J., Palm, F., Bruley, D.F. and Harrison, D.K., Eds., Oxygen Transport to Tissue XXXIV, Vol. 765, Springer, New York, 211-216. [Google Scholar] [CrossRef] [PubMed]
[37] Bion, J.F. (2000) Susceptibility to Critical Illness: Reserve, Response and Therapy. Intensive Care Medicine, 26, S57-S63. [Google Scholar] [CrossRef] [PubMed]
[38] Wang, Y., Wei, R.B., Su, T.Y., Huang, M.-J., Li, P. and Chen, X.-M. (2019) Clinical and Pathological Factors of Renal Anaemia in Patients with IgA Nephropathy in Chinese Adults: a Cross-Sectional Study. BMJ Open, 9, e023479. [Google Scholar] [CrossRef] [PubMed]
[39] Molnar, M.Z., Mehrotra, R., Duong, U., Kovesdy, C.P. and Kalantar-Zadeh, K. (2011) Association of Hemoglobin and Survival in Peritoneal Dialysis Patients. Clinical Journal of the American Society of Nephrology, 6, 1973-1981. [Google Scholar] [CrossRef
[40] Yogasundaram, H., Chappell, M.C., Braam, B. and Oudit, G.Y. (2019) Cardiorenal Syndrome and Heart Failure-Challenges and Opportunities. Canadian Journal of Cardiology, 35, 1208-1219. [Google Scholar] [CrossRef] [PubMed]