Correlation of Albumin Serum Levels as Inflammation Marker with Red Blood Cell Distribution Width Value in Regular Hemodialysis Patients at H. Adam Malik General Hospital Medan

Abstract

Background: One of the modalities of renal replacement therapy in chronic kidney disease (CKD) is hemodialysis (HD). The role of inflammation in HD patients by uremic toxins and dialysis can be assessed by the marker of serum albumin. This inflammation also causes dysregulation of the hormone erythropoietin which results in increased variability or heterogeneity of red blood cell distribution width (RDW). Previous studies have revealed an association between RDW and albumin levels in regular HD patients which leads to increased patient morbidity and mortality. This study aims to determine the relationship between albumin serum levels and RDW as a marker of inflammation in regular HD patients. Method: This was a cross sectional study design, conducted in June to August 2020 at the HD unit of Haji Adam Malik General Hospital in Medan. Twenty subjects were included. Data were analyzed using Pearson correlation test and T-test to find the correlation between albumin serum levels and RDW, and other variables. Results: Of the 20 subjects taken based on consecutive sampling, the majority was male, 13 people (65%), mean age was 50.30 ± 12.57 years with the most comorbid type 2 diabetes mellitus for 14 people (70%). The mean serum albumin level was 3.2 ± 0.65 mg/dl. The mean RDW value was 15.93 ± 1.87%. This study showed that there was a significant relationship between serum albumin levels and RDW values ​​(r = - 0.687; p = 0.001). RDW values ​​were also significantly associated with hemoglobin levels (r = 0.497; p = 0.026) and creatinine (r= 0.519; p= 0.019). Conclusion: Albumin, hemoglobin, and creatinine levels were significantly associated with RDW values ​​in regular HD patients. Keywords: inflammation, albumin, regular hemodialysis, RDW.