The Relationship Between Red Cell Distribution Width,Hypersensitive C-reactive Protein And Left Ventricular Hypertrophy In Patients With Maintenance Hemodialysis

Objective:To investigate the relationship between red blood cell distribution width(RDW),High-sensitivity c-reactive protein(hsCRP)and left ventricular hypertrophy(LVH)in patients with maintenance hemodialysis(MHD),so as to provide theoretical basis for the early detection and intervention of LVH in MHD patients.Methods:Retrospective analysis of 195 cases of end-stage renal disease(ESRD)patients who were treated with maintenance hemodialysis at 3 months or more in the department of nephrology,first hospital of shanxi medical university from January 2014 to August 2018.Collect the patient’s general information,laboratory index and cardiac ultrasound examination results,then patients were divided into LVH group(n=104)and non-LVH group(n=91)according to left ventricular mass index(LVMI).The comparison of clinical indicators between the two groups and the correlation analysis of LVMI and RDW,hsCRP and other clinical indicators and risk factor analysis of LVH were conducted,and the predictive value of RDW and hsCRP was further evaluated by ROC curve and area under curve(AUC).Results:1.There were 104 patients in the LVH group,including 58 males and 46 females.A total of 91 patients were in the non-LVH group,including 71 males and 20 females.Compared with non-LVH group,patients in the LVH group had higher RDW(15.30(14.70,16.80)%,Z=-8.830,P<0.001)and hsCRP(4.95(2.03,10.70)mg/L,Z=-3.922,P<0.001).SBP(t=-2.199,P<0.05)and NT-proBNP(Z=-3.987,P<0.001)levels were also higher,while ALB(t=2.586,P=0.010),HB(t=2.674,P=0.008),TC(t=2.733,P=0.007),TG(Z=-2.190,P=0.029)levels were lower.2.Spearman correlation analysis showed that SBP(r=0.185,P=0.010),RDW(r=0.552,P=<0.001)and hsCRP(r=0.274,P=<0.001)were positively correlated with LVMI,while ALB(r=-0.157,P=0.029),HB(r=-0.242,P=0.001)and ejection fraction(r=-0.369,P=<0.001)were negatively correlated with LVMI.3.Logistic regression analysis showed that,RDW(OR=2.248,95%CI 1.641-3.081,P<0.001),hsCRP(OR=1.111,95%CI 1.026-1.203,P=0.010),age(P=0.001),gender(P=0.004),albumin(P=0.018),SBP(P=0.032)were independent risk factors for left ventricular hypertrophy.4.ROC curve analysis performed that the area under the curve predicted by RDW was 0.867,with a sensitivity of 82.7% and a specificity of 82.4%.The area under the curve of hsCRP was 0.663,with a sensitivity of 66.3%,and a specificity of 62.6%.The area under the curve increased by 0.876 after combining them.Conclusion:Higher RDW and hsCRP were risk factors of LVH in MHD patients,and they have certain predictive value for LVH in MHD patients.clinical detection of the two indexes can provide certain theoretical basis for clinical prevention and treatment of LVH in MHD patients.