MP264ASSOCIATION OF RED BLOOD DISTRIBUTION WIDTH (RDW) WITHCAROTID ATHEROSCLEROSIS & DETERIORATION OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Abstract

Introduction and Aims: Red cell distribution width (RDW), a measure of erythrocyte size variability is routinely reported as part of complete blood count analysis & has traditionally played a role in the differential diagnosis of anemia. Recently it has been shown that higher RDW (anisocytosis) could be a novel predictor for cardiovascular events & progression of Chronic Kidney Disease (CKD). Therefore, we aimed to examine whether RDW was associated with carotid atherosclerosis & progression of CKD in patients with Diabetes Mellitus Type 2 (DMT2). Methods: In this study we included 141 patients with DMT2 (76 male and 65 female), with mean age 68.2±8.9 years & 15.2±7.8 years mean duration of DMT2. RDW, proteinuria, albuminuria & estimated glomerular filtration rate (eGFR) were assessed. All patients underwent Doppler ultrasound of the common carotid artery & Carotid Intima Media Thickness (CIMT) was determined. Stages of CKD were estimated using eGFR which was calculated via CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula. The control group was consisted by patients with DMT2 for more than 5 years duration with normal renal function. Results: A statistically significant positive correlation was revealed between RDW & hemoglobin (r=411, p<0.0001), while RDW values showed a significant inverse correlation with eGFR (r=-324, p<0.0001). Also RDW was significantly increased with progression of CKD stages (p<0.001, Kruskal-Wallis test: Stage 0-controls: 14.2±1.7, Stage 1+2: 14.6±1.8, Stage 3: 15.0±1.6, Stage 4: 15.4±1.9 & Stage 5: 16.0±2.0). Similarly, CIMT showed a significant increase with progression of CKD stages ( p=0.002, Kruskal-Wallis test). There was a significant positive correlation with both proteinuria & albuminuria (r=411, p<0.0001 and r=425, p<0.0001 respectively). Furthermore, RDW was significantly correlated with CIMT (r=206, p=0.003). Conclusions: RDW values were significantly increased with the progression of chronic diabetic nephropathy & were strongly correlated with CIMT in this group of patients. This study suggests that RDW could be a new beneficial predictor of carotid atherosclerosis & CKD progression in DMT2 patients.