What question did this study set out to answer?

This research aims to determine the role of red blood cell distribution width (RDW) as a predictor of late thrombosis in arteriovenous fistulas (AVF).

March 22, 2026Open Access

Red Blood Cell Distribution Width as a Risk Factor for Late Arteriovenous Fistula Thrombosis in Maintenance Hemodialysis Patients: A Retrospective Cohort Study

Puntos clave

This research aims to determine the role of red blood cell distribution width (RDW) as a predictor of late thrombosis in arteriovenous fistulas (AVF).
Conducted a retrospective analysis of data from 110 patients admitted between June 2017 and May 2022.
Compared 50 patients with late AVF thrombosis to 60 controls without thrombosis.
Analyzed correlations between RDW and other clinical factors using multivariate logistic regression and Pearson correlation.
Higher RDW and leukocyte counts were observed in the thrombosis group compared to the control group (P < 0.01).
RDW was positively correlated with CRP, red blood cell count, PLR, NLR, and blood phosphorus.
RDW was identified as an independent risk factor for late AVF thrombosis (OR = 1.774, P < 0.05).
AUC for RDW predicting late thrombosis was 0.702, with an optimal cutoff value of 15.30%.

Resumen

Objective: To investigate the predictive value of red blood cell distribution width (RDW) for late thrombosis in arteriovenous fistula (AVF). Methods: A retrospective analysis was conducted on data from 50 patients with late AVF thrombosis admitted to Yangpu Hospital between June 2017 and May 2022 were collected. 60 patients with AVF but without thrombosis were recruited from the same institution during the same study period were selected as the control group. The correlation between RDW and other data was analyzed. Statistically significant risk factors were analyzed by multivariate logistic regression. The ROC curve was used to evaluate the value of RDW in predicting late AVF thrombosis. Results: The values of RDW and leukocyte count in the thrombosis group were higher than those in the control group (P < 0.01). The levels of CRP, PLR, NLR, and neutrophils in the thrombosis group were higher than those in the control group (P < 0.05). Pearson correlation analysis showed that RDW was positively correlated with CRP, red blood cell count, PLR, NLR, and blood phosphorus. Multivariate logistic regression analysis showed that RDW (OR = 1.774, 95% CI: 1.055– 2.983, P< 0.05) was an independent risk factor for late AVF thrombosis. ROC curve analysis displayed that the area under the curve (AUC) for RDW was 0.702 (95% CI: 0.59 6– 0.808, P< 0.001). The optimal predictive cutoff value for RDW, calculated according to the Youden index, is 15.30%. Using RDW ≥ 15.30% to predict late AVF thrombosis yielded a sensitivity of 60.00% and a specificity of 98.30%. Conclusion;: RDW exhibits distinct expression patterns in late AVF thrombosis and demonstrates significant diagnostic potential. Incorporating this marker into existing diagnostic algorithms may enhance early risk prediction. However, further validation in large-scale, prospective multicenter studies is required to establish its clinical utility in routine practice. Keywords: red blood cell distribution width, RDW, arteriovenous fistula, thrombosis

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