Association of hemoglobin and red cell distribution width ratio with new cardiovascular events in peritoneal dialysis patients.

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Title:	Association of hemoglobin and red cell distribution width ratio with new cardiovascular events in peritoneal dialysis patients.
Alternate Title:	Relación entre la ratio hemoglobina-ancho de distribución de los glóbulos rojos y nuevos eventos cardiovasculares en pacientes en diálisis peritoneal.
Authors:	Wei, Rong¹, Zhang, Wenying¹, Tian, Na², Zhan, Xiaojiang³, Peng, Fenfen⁴, Wang, Xiaoyang⁵, Xu, Qingdong⁶, Su, Ning⁷, Wu, Juan⁸, Tang, Xingming⁸, Feng, Xiaoran⁹, Wu, Xianfeng¹⁰, Zhou, Qian¹¹, Xie, Zhiyong¹, Liang, Jianbo¹, Wen, Yueqiang¹ yueqiangwen@163.com
Source:	Nefrologia. Dec2025, Vol. 45 Issue 10, p1-7. 7p.
Subjects:	HEMOGLOBINS, PERITONEAL dialysis, BLOOD volume, CARDIOLOGICAL manifestations of general diseases, STATISTICS, DISEASE risk factors, SURVIVAL analysis (Biometry)
Abstract (English):	Objective: Peritoneal dialysis (PD) patients, who are more likely to have a poor prognosis for new cardiovascular events (CVE), are the focus of our research. We aim to investigate whether the hemoglobin-tored cell distribution width (HRR) ratio is associated with a higher risk of new-onset CVE in PD patients. This research could potentially lead to new strategies for predicting and preventing new-onset CVE in PD patients. Methods: One thousand four hundred seventy-four patients from November 1, 2005, to December 31, 2016, were divided into high and low HRR groups using restricted cubic spline (RCS). Various statistical methods were utilized to study the impact of HRR changes on new-onset CVE in PD patients, including Kaplan–Meier cumulative incidence curves, multivariate COX regression, competitive risk analysis, and forest plots to analyze subgroup interactions. Results: During the follow-up period, 104 new-onset CVEs were recorded. Restricted cubic spline showed a non-linear relationship between HRR and new-onset CVE. A multifactorial COX regression analysis model showed reduced HRR as an independent risk factor for new-onset CVE (HR, 1.737; 95% CI 1.119–2.695, P = 0.014). Kaplan–Meier analysis showed a significant difference in survival between the two groups of patients (P = 0.002). The competing risks model found that after excluding endpoint events, there was still a significant difference in new-onset CVE (P = 0.0009) between the different HRR groups. In subgroup analyses, there were no significant differences between groups. Conclusions: Low hemoglobin to red cell distribution width ratio (HRR) is associated with a higherrisk of newonset CVE in PD patients. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Objetivo: Los pacientes en diálisis peritoneal (DP), que tienen más probabilidades de tener un mal pronostico ́ debido a nuevos eventos cardiovasculares (ECV),son el foco de nuestro estudio. Nuestro objetivo es estudiar si la ratio hemoglobina-ancho de distribucioń de globulos ́ rojos (HRR) está relacionada con un mayor riesgo de ECV de nueva aparicioń en pacientes con DP. Este estudio puede conducir a nuevas estrategias para predecir y prevenir nuevos ECV en pacientes con DP. Métodos: Entre el 1 de noviembre de 2005 y el 31 de diciembre de 2016, 1.474 pacientes usaron spline cúbicos restringidos y se dividieron en grupos de HRR alta y HRR baja. Se utilizaron varios métodos estadísticos para estudiar el impacto de los cambios en la HRR en el ECV de nueva aparicioń en pacientes con DP, incluyendo la curva de incidencia acumulada Kaplan-Meier, la regresioń múltiple de Cox, el análisis de riesgo competitivo y el diagrama de bosque para analizar la interaccioń de subgrupos. Resultados: Durante el seguimiento se registraron 104 nuevos ECV. La restriccioń de los spline cúbicos muestra una relacioń no lineal entre HRR y el nuevo ECV. El modelo de análisis de regresioń de Cox multifactorial mostróque la disminucioń de la HRR fue un factor de riesgo independiente para el nuevo ECV (HR 1.737; 95% CI 119-2.695, p = 0014). El análisis de Kaplan-Meier mostródiferencias significativas en la supervivencia entre los 2 grupos de pacientes (p = 0002). El modelo de riesgo competitivo encontró que después de excluir el evento final, todavía había diferencias significativas en los nuevos ECV entre los diferentes grupos de HRR (p = 0,0009). En el análisis de subgrupos, no se encontraron diferencias significativas entre los grupos. Conclusion: ́ Una baja HRR está relacionada con un mayor riesgo de ECV de nueva aparicioń en pacientes con DP. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Objective: Peritoneal dialysis (PD) patients, who are more likely to have a poor prognosis for new cardiovascular events (CVE), are the focus of our research. We aim to investigate whether the hemoglobin-tored cell distribution width (HRR) ratio is associated with a higher risk of new-onset CVE in PD patients. This research could potentially lead to new strategies for predicting and preventing new-onset CVE in PD patients. Methods: One thousand four hundred seventy-four patients from November 1, 2005, to December 31, 2016, were divided into high and low HRR groups using restricted cubic spline (RCS). Various statistical methods were utilized to study the impact of HRR changes on new-onset CVE in PD patients, including Kaplan–Meier cumulative incidence curves, multivariate COX regression, competitive risk analysis, and forest plots to analyze subgroup interactions. Results: During the follow-up period, 104 new-onset CVEs were recorded. Restricted cubic spline showed a non-linear relationship between HRR and new-onset CVE. A multifactorial COX regression analysis model showed reduced HRR as an independent risk factor for new-onset CVE (HR, 1.737; 95% CI 1.119–2.695, P = 0.014). Kaplan–Meier analysis showed a significant difference in survival between the two groups of patients (P = 0.002). The competing risks model found that after excluding endpoint events, there was still a significant difference in new-onset CVE (P = 0.0009) between the different HRR groups. In subgroup analyses, there were no significant differences between groups. Conclusions: Low hemoglobin to red cell distribution width ratio (HRR) is associated with a higherrisk of newonset CVE in PD patients. [ABSTRACT FROM AUTHOR]
ISSN:	02116995
DOI:	10.1016/j.nefroe.2025.501370