Predictive analysis of red blood cell distribution width-to-platelet ratio for arteriovenous fistula dysfunction in maintenance hemodialysis patients with end-stage renal disease
10.3760/cma.j.cn115455-20240322-00264
- VernacularTitle:红细胞分布宽度与血小板比值对终末期肾病维持性血液透析患者动静脉内瘘失功的预测分析
- Author:
Ping HE
1
;
Rui XU
;
Qiuju HUA
;
Lu JIANG
;
Weiping WANG
Author Information
1. 扬州市江都人民医院肾内科，扬州 225200
- Keywords:
Nephrosis;
Platelet;
End-stage;
Maintenance hemodialysis;
Arteriovenous fistula;
Red blood cell distribution width
- From:
Chinese Journal of Postgraduates of Medicine
2024;47(11):988-994
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive value of red blood cell distribution width-to-platelet ratio (RPR) on arteriovenous fistula (AVF) dysfunction in maintenance hemodialysis patients with end-stage renal disease (ESRD).Methods:One hundred and five ESRD patients who underwent maintenance hemodialysis with autologous AVF in Jiangdu People′s Hospital from March 2021 to March 2023 were selected. The red blood cell distribution width (RDW) and platelet (PLT) levels were measured before the start of dialysis, and the RPR was calculated. All patients were followed up for 6 months, and AVF dysfunction was recorded and divided into dysfunction group and non dysfunction group. The levels of RDW, PLT, and RPR before dialysis were compared between the two groups. Univariate and multivariate Logistic regression analyses were used to examine the relationship between RDW, PLT, RPR and AVF dysfunction in ESRD maintenance hemodialysis patients. Receiver operating characteristic (ROC) curves were plotted to obtain the area under the curve (AUC) for RDW analysis the predictive value of PLT and RPR for AVF dysfunction in ESRD maintenance hemodialysis patients.Results:Among the 105 patients, 4 were excluded due to interruption of treatment and transfer to another hospital. Among the 101 patients ultimately enrolled, 19 patients experienced AVF dysfunction (dysfunction group), with an incidence rate of 18.81% (19/101); 80 patients did experience AVF dysfunction (non dysfunction group). C-reactive protein, RDW and RPR in the dysfunction group were higher than those in the non dysfunction group: (7.36 ± 1.92) mg/L vs. (5.90 ± 2.40) mg/L, (17.98 ± 2.40)% vs. (14.96 ± 2.29)%, 0.14 ± 0.03 vs. 0.11 ± 0.02, the proportion of diabetes patients was higher than that in the non dysfunction group, while albumin was lower than that in the non dysfunction group: (33.49 ± 2.78) g/L vs. (35.01 ± 3.02) g/L, with a statistical significant difference ( P<0.05). Multivariate Logistic regression analysis showed that C-reactive protein, RDW, RPR were all associated with AVF dysfunction in ESRD maintenance hemodialysis patients ( P<0.05). ROC curve was drawn, and the results showed that the AUC of RDW and RPR predicting AVF dysfunction in ESRD maintenance hemodialysis patients was greater than 0.7, and the AUC of RPR was higher, 0.840 (95% CI 0.752 to 0.928), with an optimal cutoff value of 0.125, specificity of 78.90%, and sensitivity of 73.20%. Conclusions:RDW and RPR are both associated with AVF dysfunction in ESRD maintenance hemodialysis patients, and may have certain predictive value for AVF dysfunction.
