Distribution Width of Red Blood Cells and Related Factors Among Patients with End-Stage Renal Disease in Addis Ababa, Ethiopia

Abstract

Background

RDW is critical to the clinical diagnosis and progression of ESRD. There is currently little data on the relationship between RDW and ESRD in sub-Saharan Africa. Because of this, the present study evaluates RDW in patients with ESRD and associated factors in Addis Ababa, Ethiopia.

Methods

The hospital-based cross-sectional study design was conducted on a total of 83 patients. RDW, MCV, SCR, BUN, GFR, FBS and serum albumin were determined. Blood pressure (mmHg), weight (kg), height (m), MUAC (cm) and BMI (kg/m2) were also measured. Data entry was via Epi-data version 3.4 and analyzed with SPSS version 26.0. A multivariate logistic regression analysis with a p-value < 0.05 at a 95% confidence interval was used to identify the associated factors of RDW.

Results

A total of 83 ESRD patients participated, with a response rate of 95.4%. RDW ranged from 15.5% to 23.6% with a mean of 17.40% + 1.46%. Anisocytosis was present in 98.8% of patients. Of 83 patients, 66.3% were hypertensive, 20.5% had diabetes, and the remaining 13.3% had other conditions (glomerulonephritis and peripheral vascular disease). The mean GFR value was 5.20 mL/min/1.73 + 1.58. RDW showed a significant association with GFR (AOR: 4.6, 95% CI [1.27, 20.74], P = 0.047), alcohol consumption (AOR: 13.4, P = 0.012, 95% CI [1.97, 22.62]), recurrent kidney disease (AOR=25.6, P=0.016, 95% CI [1.85, 53.71]) and use of medication (AOR=00.2, P=0.044), 95% CI [0.03, 0.95]).

Conclusion

RDW showed a significant association with GFR, recurrent kidney disease, alcohol consumption, and medication use in hemodialysis-dependent ESRD patients. The mechanisms of RDW disruption in ESRD patients need further investigation.

Keywords:

• red cell distribution width
• end stage renal disease
• glomerular filtration rate
• serum creatinine
• mean corpuscular volume
• body mass index
• blood urea nitrogen
• mid-upper arm circumference

Acknowledgments

We thank the staff of the Department of Physiology, Faculty of Medicine, Addis Ababa University for their collaboration. We also thank volunteers who participated in this study. Finally, we would also like to express our appreciation for Debre Berhan University.

Author Contributions

All authors made significant contributions to the reported work, whether in conception, study design, implementation, data collection, analysis and interpretation, or all of these areas; were involved in drafting, revising, or critically reviewing the article; give final approval of the version to be published; agreed on the journal to which the article was submitted; and agreed to be responsible for all aspects of the work.

Disclosure

This paper was done for the fulfilment of Master’s Degree in Medical Physiology from Addis Ababa University. Since it is a must to give a full thesis after successful defense for Addis Ababa University Library to put it online for the purpose of reading for students. So that it is available online in Addis Ababa University Library Circulation. But it is our original work paper which is not a published yet. The authors declare no conflicts of interest in relation to this, and all authors are responsible for the content and writing of this document.