Association of red blood cell distribution width and hemoglobin‐to‐RDW ratio with contrast‐associated acute kidney injury in patients undergoing coronary angiography: A retrospective study

Abstract

BackgroundInflammation contributes to poor prognosis in cardiovascular diseases. A novel biomarker for systemic inflammation that has garnered attention is the red blood cell distribution width (RDW). This study is designed to explore potential associations between RDW and hemoglobin‐to‐RDW ratio (HRR) with contrast‐associated acute kidney injury (CA‐AKI).MethodsThis study retrospectively analyzed 4054 patients undergoing coronary angiography (CAG). Linear regression models were employed to assess the relationships between RDW or HRR and the elevation of serum creatinine (Scr). The associations between RDW or HRR and CA‐AKI were explored using restricted cubic spline and log‐binomial regression analyses taking into account specific cutoff values and quintiles. Exploratory analyses were also conducted to further investigate these associations.ResultsAmong enrolled patients, the average age was 66.9 years and 34.3% were female. Notably, patients who developed CA‐AKI tended to have higher RDW and lower HRR. Multivariable linear regression models demonstrated that RDW exhibited a positive association with Scr elevation (β = 2.496, 95% confidence interval [CI] = 1.784–3.208), while HRR displayed a negative association (β = −3.559, 95% CI = −4.243 to −2.875). Multivariable log‐binomial regression models confirmed that both high RDW (RDW ≥ 13.8%) and low HRR (HRR < 8.9) were significantly associated with a higher risk of CA‐AKI (RDW [≥13.8% vs. <13.8%]: relative risk [RR] = 1.540, 95% CI = 1.345–1.762; HRR [<8.9 vs. ≥8.9]: RR = 1.822, 95% CI = 1.584–2.096). Exploratory analysis determined that such associations still existed regardless of age, gender, estimated glomerular filtration rate, or anemia.ConclusionsElevated preoperative RDW and decreased HRR were significantly associated with CA‐AKI in patients undergoing CAG.

Inflammatory Indices Derived from Hemogram as Prognostic Markers of Cardiovascular Outcome

“…The Hb/RDW ratio is used as a new inflammation marker in malignancies, such as esophageal, small cell lung and pancreatic cancers, and in systemic diseases, such as acute kidney injury. 13 Apart from the studies in literature, Kilic et al have investigated the prognostic role of Hb/RDW ratio in patients with acute coronary syndrome and reported its high sensitivity and specificity in predicting those patients' outcome. 1 Blood Hb level refers to the oxygen-carrying capacity of an organism.…”