Abstract：Objective To study the clinical value of red blood cell distribution width (RDW) in the early prediction of acute kidney injury (AKI) in children with sepsis.Methods A total of 126 children with sepsis were divided into an AKI group (n=66) and a non-AKI group (n=60) according to the presence or absence of AKI. These patients were also classifed into high-RDW and low-RDW groups according to the mean RDW. The groups were compared in terms of age, male-to-female ratio, body mass index (BMI), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, Sequential Organ Failure Assessment (SOFA) score, serum blood urea nitrogen (BUN), creatinine (Cr), uric acid (UA), serum C-reactive protein (CRP), and routine blood test results. Independent factors associated with RDW were analyzed by multiple linear regression.Results Age, male-to-female ratio, BMI, CRP, SOFA score, and APACHE Ⅱ score did not differ signifcantly between the AKI and non-AKI groups (P > 0.05), but the AKI group had signifcantly higher BUN, Cr, UA, and RDW levels than the non-AKI group (P < 0.05). Age, male-to-female ratio, and BMI did not differ signifcantly between the high-RDW and low-RDW groups (P > 0.05), but the high-RDW group had signifcantly higher BUN, Cr, UA, CRP, SOFA score, APACHE Ⅱ score, Hb, and mean corpuscular volume (MCV) than the lowRDW group (P < 0.05). The multiple linear regression analysis showed that age, sex, APACHE Ⅱ score, Cr, Hb, and MCV were independent factors associated with RDW.Conclusions RDW has a certain clinical value in the early prediction of AKI in children with sepsis.
ZHANG Lin,GUO Kuan-Peng,MO Yi et al. Predictive value of red blood cell distribution width for acute kidney injury in children with sepsis[J]. CJCP, 2018, 20(7): 559-562.
Fleischmann C, Thomas-Rueddel DO, Hartmann M, et al. Hospital incidence and mortality rates of sepsis[J]. Dtsch Arztebl Int, 2016, 113(10):159-166.
[2]
Poukkanen M, Vaara ST, Pettilä V, et al. Acute kidney injury in patients with severe sepsis in Finnish intensive care units[J]. Acta Anaesthesiol Scand, 2013, 57(7):863-872.
[3]
Li ZZ, Chen L, Yuan H,et al. Relationship between red blood cell distribution width and early-stage renal function damage in patients with essential hypertension[J]. J Hypertens, 2014, 32(12):2450-2455.
[4]
Lippi G, Targher G, Montagnana M, et al. Relationship between red blood cell distribution width and kidney function tests in a large cohort of unselected outpatients[J]. Scand J Clin Lab Invest, 2008, 68(8):745-748.
Mahmood NA, Mathew J, Kang B, et al. Broadening of the red blood cell distribution width is associated with increased severity of illness in patients with sepsis[J]. Int J Crit Illn Inj Sci, 2014, 4(4):278-282.
Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Defnitions Conference[J]. Crit Care Med, 2003, 31(4):1250-1256.
[9]
Bellomo R, Ronco C, Kellum JA, et al. Acute renal failure-definition, outcome measures, animal models, fluid therapy and information technology needs:the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group[J]. Crit Care, 2004, 8(4):R204-R212.
[10]
Lu JL, Molnar MZ, Naseer A, et al. Association of age and BMI with kidney function and mortality:a cohort study[J]. Lancet Diabetes Endocrinol, 2015, 3(9):704-714.
[11]
Hoffmann JJ, Nabbe KC, van den Broek NM. Effect of age and gender on reference intervals of red blood cell distribution width (RDW) and mean red cell volume (MCV)[J]. Clin Chem Lab Med, 2015, 53(12):2015-2019.
[12]
Lippi G, Salvagno GL, Guidi GC. Red blood cell distribution width is signifcantly associated with aging and gender[J]. Clin Chem Lab Med, 2014, 52(9):e197-e199.
[13]
Souza AC, Volpini RA, Shimizu MH, et al. Erythropoietin prevents sepsis-related acute kidney injury in rats by inhibiting NF-κB and upregulating endothelial nitric oxide synthase[J]. Am J Physiol Renal Physiol, 2012, 302(8):F1045-F1054.
