Objective To investigate the predictive value of red cell distribution width (RDW) combined with alkaline phosphatase (ALP) for cardiovascular events in patients with maintenance hemodialysis (MHD).
Methods A total of 262 MHD patients from Taicang First People's Hospital in Jiangsu Province from January 2019 to December 2021 were selected as the study objects, and 245 patients were eventually included. The patients were divided into CVE group (44 cases) and non-CVE group (201 cases). Clinical data and related laboratory indexes were compared between the two groups; the correlations of RDW and ALP with laboratory indexes were analyzed by Pearson correlation analysis; the risk factors of CVE in MHD patients were analyzed by Cox regression; the receiver operating characteristic (ROC) curves were used to analyze RDW, ALP and RDW-ALP combined to detect the area under the curve (AUC) of CVE in MHD patients.
Results Among the included MHD patients, CVE occurred in 44 cases, accounting for 17.96%. There were statistically significant differences in age, presence or absence of combining with pre-dialysis hypertension, presence or absence of complicating with diabetes, hemoglobin, albumin, high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), blood phosphorus, RDW and ALP between the two groups (P < 0.05). Increased age (HR=1.101, 95%CI, 0.998 to 1.154, P=0.02), combined with diabetes (HR=1.212, 95%CI, 1.007 to 1.458, P=0.012), increased RDW (HR=1.014, 95%CI, 0.874 to 1.383, P=0.03), increased ALP (HR=1.024, 95%CI, 1.006 to 1.042, P=0.008), increased NT-proBNP (HR=1.15; 95%CI, 1.05 to 1.67; P=0.041) were independent risk factors for CVE in MHD patients. AUC predicted by RDW was 0.792 for CVE, 0.737 for ALP, and 0.866 for RDW-ALP. The AUC of RDW-ALP combined prediction was significantly greater than that of RDW and ALP alone (P < 0.05).
Conclusion RDW and ALP are effective indicators for predicting CVE in MHD patients, and their combined detection can improve the predictive value.
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