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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Association Between Red Cell Distribution Width and In-Hospital Mortality in Patients With Chronic Kidney Disease: A
Alpana Meena1, Gunjalika Kag1, Yashoverdhan Kag1
1General Medicine, Lakshmi Narain Medical College and Research Center, Bhopal, IND.
Cureus
|June 8, 2026
Summary
Elevated red cell distribution width (RDW) independently predicts mortality in hospitalized chronic kidney disease (CKD) patients in India. This accessible marker aids early risk stratification, especially in resource-limited settings.
Area of Science:
- Nephrology
- Cardiology
- Hematology
Background:
- Elevated red cell distribution width (RDW) is a known mortality predictor in cardiovascular and chronic kidney disease (CKD) globally.
- Data on RDW's prognostic value in Indian non-dialysis CKD patients, a population with high sepsis and late presentation rates, is limited.
Purpose of the Study:
- To evaluate red cell distribution width (RDW) as a prognostic marker for in-hospital mortality.
- To assess the association between RDW and mortality in hospitalized non-dialysis CKD patients in an Indian tertiary care setting.
Main Methods:
- Retrospective, single-center cohort study of 176 adult non-dialysis CKD patients.
- Multivariable logistic regression analysis adjusted for sepsis, heart failure, coronary artery disease, and albumin.
- Receiver operating characteristic (ROC) curve analysis to assess discrimination (Area Under the Curve - AUC).
Main Results:
- In-hospital mortality rate was 24.4% (43/176).
- Non-survivors exhibited significantly higher median RDW (16.1% vs. 14.2%, p < 0.001).
- RDW independently predicted mortality (adjusted OR = 1.30 per 1% increase), with moderate discrimination (AUC = 0.696). Multivariable model AUC improved to 0.774.
Conclusions:
- Elevated RDW is an independent predictor of in-hospital mortality in advanced CKD patients in India.
- RDW serves as a low-cost, accessible marker for early risk stratification in resource-limited settings.
- Prospective external validation is recommended to confirm these findings.
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