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Abstract
The association between increased red blood cell distribution width (RDW) and mortality among patients treated on an outpatient basis in the nephrology outpatient clinic is unclear. Therefore, our study aimed to investigate the association between baseline and time-averaged RDW and mortality risk in patients treated in our nephrology outpatient clinic. Our multi-center retrospective analysis was based on data of 16,417 outpatient nephrology patients with available baseline renal function and RWD values. The median baseline RDW was 13.0% (range, 10.0–32.1%). The high-RDW group was defined as the top quartile (≥ 13.8%, n = 4302). The crude mortality rate was 15.0% (n = 1806) at a median follow-up of 127.5 months. From the results of the multivariate Cox proportional hazards regression model adjusted for covariates, including eGFR, hemoglobin, and factors of anemia treatment, patients with a high time-averaged RDW had increased mortality risk (adjusted hazard ratio, 1.505; 95% confidence interval, 1.326–1.708; P < 0.001), irrespective of sex, presence of anemia, and chronic kidney disease, except in individuals aged < 45 years. Thus, increased baseline and time-averaged RDW were significantly associated with increased mortality in patients aged > 45 years treated on an outpatient basis in the nephrology clinic.
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Details
1 Ulsan University Hospital, University of Ulsan College of Medicine, Department of Internal Medicine, Ulsan, Korea (GRID:grid.267370.7) (ISNI:0000 0004 0533 4667)
2 Sheikh Khalifa Specialty Hospital, Department of Nephrology, Ras al Khaimah, United Arab Emirates (GRID:grid.267370.7)
3 Seoul National University Hospital, Department of Internal Medicine, Seoul, Korea (GRID:grid.412484.f) (ISNI:0000 0001 0302 820X)
4 Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Department of Internal Medicine, Seoul, Korea (GRID:grid.470090.a) (ISNI:0000 0004 1792 3864)
5 Seoul National University Boramae Medical Center, Department of Internal Medicine, Seoul, Korea (GRID:grid.412479.d)
6 Seoul National University Hospital, Department of Internal Medicine, Seoul, Korea (GRID:grid.412484.f) (ISNI:0000 0001 0302 820X); Seoul National University College of Medicine, Department of Internal Medicine, Seoul, Korea (GRID:grid.31501.36) (ISNI:0000 0004 0470 5905); Seoul National University College of Medicine, Kidney Research Institute, Seoul, Korea (GRID:grid.31501.36) (ISNI:0000 0004 0470 5905)
7 Seoul National University Boramae Medical Center, Department of Internal Medicine, Seoul, Korea (GRID:grid.412479.d); Seoul National University College of Medicine, Department of Internal Medicine, Seoul, Korea (GRID:grid.31501.36) (ISNI:0000 0004 0470 5905); Seoul National University College of Medicine, Kidney Research Institute, Seoul, Korea (GRID:grid.31501.36) (ISNI:0000 0004 0470 5905)