Original Article

Analysis of the Relationships between Mean Red Blood Cell Volume, Red Blood Cell Distribution Width and Hypotension in Patients with Hemodialysis


Background: We aimed to explore and analyze the relationships between mean corpuscular volume (MCV), red blood cell distribution width (RDW) and hypotension in patients with hemodialysis.

Methods: The clinical data of 163 patients from the Xinghua People’s Hospital, Taizhou, China with hemodialysis were retrospectively analyzed. The incidence of hypotension was counted and the levels of MCV and RDW were compared between the patients with and without hemodialysis. MCV and RDW were analyzed as possible influencing factors of hypotension. Receiver operating characteristic curve (ROC) was drawn to analyze the effect of MCV and RDW on the risk assessment of hypotension in patients with hemodialysis.

Results: MCV in patients with hypotension was significantly lower than those without hypotension (P < 0.05), and RDW was higher than those without hypotension (P < 0.05). The constituent ratio of higher age (>60), diabetic nephropathy, maintenance hemodialysis, MCV < 80fl, RDW > 14.8%, malnutrition, anemia, ultra-filtration rate, diet during dialysis, coronary heart disease, atrial fibrillation and antihypertensive drugs before dialysis were higher in patients with hypotension than those without hypotension (P < 0.05). The sensitivity, specificity and AUC of the combination of MCV and RDW were higher than those of the single assessment. MCV is lower in patients with hypotension and RDW is higher than those in patients without hypotension.

Conclusion: MCV combined with RDW has a good evaluation effect.

1. Jin DC (2019). Analysis of mortality risk from Korean hemodialysis registry data 2017. Kidney Res Clin Pract, 38(2): 169-175.
2. Gao ZH, Liu J, Ji DX (2017). Management of hypotension in hemodialysis. Zhongguo Xueye Jinghua, 16: 293-296.
3. Mc Causland FR, Waikar SS (2015). Associa-tion of Predialysis Calculated Plasma Osmolarity With Intradialytic Blood Pres-sure Decline. Am J Kidney Dis, 66(3): 499-506.
4. Csiky B, Sági B, Peti A, et al (2017). The Im-pact of Osteocalcin, Osteoprotegerin and Osteopontin on Arterial Stiffness in Chronic Renal Failure Patients on Hemo-dialysis. Kidney Blood Press Res, 42(6): 1312-1321.
5. Mo L, Chen Y, Li Z, et al (2017). Red blood cell distribution width as a marker of cer-ebral infarction in hemodialysis patients. Ren Fail, 39(1): 712-718.
6. Gellert R, Billip-Tomecka Z, Hijaz H, et al (1991). Intradialytic erythrocyte volume changes. Nephrol Dial Transplant, 6 Suppl 3: 10-13.
7. Cruz M C D L, Y Diéguez (2007). [Low blood pressure in hemodialysis]. Nefrolo-gia, 27(3): 387-8.
8. Booth J, Pinney J, Davenport A (2010). Changes in Red Blood Cell Size and Red Cell Fragmentation during Hemodialysis. Int J Artif Organs, 33(12): 900-5.
9. Clarkson MJ, Fraser SF, Bennett PN, et al (2017). Efficacy of blood flow restriction exercise during dialysis for end stage kid-ney disease patients: protocol of a ran-domised controlled trial. BMC Nephrol, 18(1): 294.
10. Fukasawa H, Ishibuchi K, Kaneko M, et al (2017). Red Blood Cell Distribution Width Is Associated With All-Cause and Cardiovascular Mortality in Hemodialysis Patients. Ther Apher Dial, 21(6): 565-571.
11. Zhang T, Li J, Lin Y, et al (2017). Associa-tion Between Red Blood Cell Distribution Width and All-cause Mortality in Chronic Kidney Disease Patients: A Systematic Review and Meta-analysis. Arch Med Res, 48(4): 378-385.
12. Chen X, Shen B, Zou J, et al (2016). The Prognostic Value of Red Blood Cell Dis-tribution Width in Patients on Mainte-nance Hemodialysis. Blood Purif, 42(4): 314-321.
13. Zhu RZ, Gao ZH, Wang XY, et al (2018). The correlation between red blood cell distribution width and hemodialysis hy-potension. Zhongguo Xueye Jinghua, 17: 24-27.
14. Toida T, Toida R, Yamashita R, et al (2019). Grading of Left Ventricular Diastolic Dysfunction with Preserved Systolic Function by the 2016 American Society of Echocardiography/European Asso-ciation of Cardiovascular Imaging Rec-ommendations Contributes to Predicting Cardiovascular Events in Hemodialysis Patients. Cardiorenal Med, 9(3): 190-200.
15. Wang ZY, Chen ZJ, Jiang ZH, et al (2017). Dialysis hypotension in hemodialysis pa-tients and its relationship with prognosis. Zhonghua Shenzangbing Zazhi, 33: 495-503.
16. Qureshi AR, Durrani N, Asif N (2018). Vital Sign Variations with Complications dur-ing Dialysis among End-Stage Renal Dis-ease Patients. J Coll Physicians Surg Pak, 28(6): 431-435.
IssueVol 50 No 11 (2021) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v50i11.7579
Red blood cell Hemodialysis Hypotension

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How to Cite
Xie J, Zhu Q, Qian Y, Yao G, Yuan Y. Analysis of the Relationships between Mean Red Blood Cell Volume, Red Blood Cell Distribution Width and Hypotension in Patients with Hemodialysis. Iran J Public Health. 2021;50(11):2246-2253.