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Association of hemoglobin and red cell distribution width ratio with new cardiovascular events in peritoneal dialysis
Rong Wei1, Wenying Zhang1, Na Tian2
1Department of Nephrology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Insights
Low hemoglobin-to-red cell distribution width (HRR) ratio is linked to increased cardiovascular events in peritoneal dialysis patients. This finding may help predict and prevent future heart issues in this vulnerable group.
Area of Science:
- Nephrology
- Cardiology
- Biomarkers
Background:
- Peritoneal dialysis (PD) patients face a higher risk of cardiovascular events (CVE).
- Identifying predictive markers for CVE in PD patients is crucial for improving outcomes.
Purpose of the Study:
- To investigate the association between the hemoglobin-to-red cell distribution width (HRR) ratio and the risk of new-onset CVE in PD patients.
- To explore the potential of HRR as a predictive tool for cardiovascular risk in PD.
Main Methods:
- A cohort of 1,474 PD patients was analyzed from November 1, 2005, to December 31, 2016.
- Patients were categorized into high and low HRR groups using restricted cubic spline (RCS).
- Statistical analyses included Kaplan-Meier curves, multivariate COX regression, and competing risk analysis.
Main Results:
- A non-linear relationship was observed between HRR and new-onset CVE.
- Reduced HRR was identified as an independent risk factor for new-onset CVE (HR, 1.737; P=0.014).
- Kaplan-Meier and competing risks analyses confirmed a significantly higher risk of CVE in the low HRR group.
Conclusions:
- A low hemoglobin-to-red cell distribution width (HRR) ratio is significantly associated with an increased risk of new-onset cardiovascular events in patients undergoing peritoneal dialysis.
- HRR may serve as a valuable biomarker for cardiovascular risk stratification in PD patients.
Objective:
Peritoneal dialysis (PD) patients, who are more likely to have a poor prognosis for new cardiovascular events (CVE), are the focus of our research. We aim to investigate whether the hemoglobin-to-red cell distribution width (HRR) ratio is associated with a higher risk of new-onset CVE in PD patients. This research could potentially lead to new strategies for predicting and preventing new-onset CVE in PD patients.
Methods:
One thousand four hundred seventy-four patients from November 1, 2005, to December 31, 2016, were divided into high and low HRR groups using restricted cubic spline (RCS). Various statistical methods were utilized to study the impact of HRR changes on new-onset CVE in PD patients, including Kaplan-Meier cumulative incidence curves, multivariate COX regression, competitive risk analysis, and forest plots to analyze subgroup interactions.
Results:
During the follow-up period, 104 new-onset CVEs were recorded. Restricted cubic spline showed a non-linear relationship between HRR and new-onset CVE. A multifactorial COX regression analysis model showed reduced HRR as an independent risk factor for new-onset CVE (HR, 1.737; 95% CI 1.119-2.695, P=0.014). Kaplan-Meier analysis showed a significant difference in survival between the two groups of patients (P=0.002). The competing risks model found that after excluding endpoint events, there was still a significant difference in new-onset CVE (P=0.0009) between the different HRR groups. In subgroup analyses, there were no significant differences between groups.
Conclusions:
Low hemoglobin to red cell distribution width ratio (HRR) is associated with a higher risk of new-onset CVE in PD patients.
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