Red Blood Cell Distribution Width Level: A Predictive Marker for Early Detection and Monitoring of Diabetic Nephropathy Progression

Abstract

Chronic inflammation may be one of the factors that contribute to the development of diabetic nephropathy (DN). However, erythropoiesis, erythrocyte circulatory half-life and erythrocyte deformability may be influenced by inflammation. Thus, red blood cell distribution width (RDW) levels increase in inflammatory conditions. We investigated the RDW values and related factors in patients with uncomplicated type 2 diabetes mellitus (DM) and diabetic patients with DN. We carried out a retrospective study on patients with type 2 DM admitted to our hospital. Subjects were divided into three groups. Group 1 consisted of healthy subjects. Group 2 consisted of patients with uncomplicated type 2 DM. Patients with various stages of DN were included in Group 3. The RDW values in group 1 subjects were significantly lower than those in group 2 and 3 patients (p<0.05). The RDW values of group 3 patients were higher than those in the other two groups (p<0.05). While the RDW values had positive correlation with blood pressure, serum creatinine, HbA1c, body mass index, proteinuria, platelet (PLT), triglyceride, low density lipoprotein (LDL), total cholesterol (TC), and fasting blood glucose (r values: 0.95, 0.72, 0.56, 0.86, 0.82, 0.76, 0.88, 0.84, 0.88, 0.86, respectively) (p<0.05 for all), there was negative correlation between estimated glomerular filtration rate (eGFR), albumin, high density lipoprotein (HDL) and RDW levels (r values: −0.92, −0. 88, −0.78, respectively) (p value < 0.05 for all).