The Association Between Red Blood Cell Distribution Width and the Severity of Diabetic Chronic Kidney Disease

Li Gu,1 Song Xue2 1Department of Endocrinology, People’s Hospital of Gaochun, Nanjing, 211300, People’s Republic of China; 2Department of Pathology, People’s Hospital of Gaochun, Nanjing, 211300, People’s Republic of ChinaCorrespondence: Li GuDepartment of Endocrinology, People’s Hospital of Gaochun, No. 53 Maoshan Road, Gaochun District Economic Development Zone, Nanjing, 211300, People’s Republic of ChinaTel +86 13851529447Email Rougu_doct@163.comPurpose: Red cell distribution width (RDW) has been evidenced to be related to various diabetes-associated macrovascular and microvascular complications. However, the studies on the association between RDW and diabetic chronic kidney disease (CKD) are still scarce. The aim of the study is to explore whether there is any association between RDW and the severity of diabetic CKD.Patients and Methods: The study recruited 396 patients diagnosed with diabetic CKD at People’s Hospital of Gaochun from January 2006 to April 2021. Baseline characteristics were gathered and laboratory tests were performed to measure clinical indexes. Patients were also categorized into three groups based on their CKD stages. Correlation analysis and multivariate ordinal logistic regression were performed to investigate the association between RDW and the severity of diabetic CKD. The risk size was described as odds ratio (OR) and 95% confidence interval (CI).Results: We found a significant association between RDW and the severity of CKD, with a correlation coefficient of 0.32 (P < 0.01). We used three models for multivariate ordinal logistic regression to investigate the relationship between RDW and the severity of CKD. Results showed that RDW is an independent and significant risk factor of diabetic CKD after adjustment for demographic data, physiological indexes, and drug history [Model 3 OR (95% CI) = 1.225 (1.023– 1.467)]. In subgroup analysis, RDW remained a significant risk factor in all three models for patients who had diabetes of 5– 10 years [Model 3 OR (95% CI) = 1.480 (1.067– 2.052)] and had a HbA1c level > 7% [(Model 3 OR (95% CI) = 1.478 (1.184– 1.845)].Conclusion: RDW is significantly associated with the disease stages of diabetic CKD, and the risk is higher for people with 5– 10 years of diabetes and for those who do not control the HbA1c level well. This study has implications for the diagnosis, monitoring, and timely treatment of the diabetic CKD.Keywords: red cell distribution width, diabetic chronic kidney disease, correlation, inflammation