ArticleCureus2026
Association Between Red Cell Distribution Width and In-Hospital Mortality in Patients With Chronic Kidney Disease: A Retrospective Cohort Study.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
Background Elevated red cell distribution width (RDW) independently predicts mortality in cardiovascular and chronic kidney disease (CKD) populations globally, but data from Indian hospitalized non-dialysis CKD patients, where sepsis and late presentations are prevalent, remain scarce. In this study, we evaluated RDW as a prognostic marker for in-hospital mortality in this setting. Methodology We conducted a retrospective, single-center cohort study of 176 adults (≥18 years) hospitalized with Kidney Disease: Improving Global Outcomes (KDIGO)-defined CKD (January 2022 to December 2024) at a tertiary Indian hospital after excluding those with acute kidney injury-on-CKD and stays <48 hours. Multivariable logistic regression assessed the RDW-mortality association, adjusted for sepsis, heart failure, coronary artery disease, and albumin. Discrimination was assessed by receiver operating characteristics (ROC)-area under the curve (AUC); bootstrapped confidence intervals (CIs) were used, given the modest event count (n = 43). Results In-hospital mortality was 24.4% (43/176). Non-survivors had significantly higher median RDW (16.1% vs. 14.2%, p < 0.001). RDW independently predicted mortality (adjusted odds ratio (OR) = 1.30 per 1% increase, 95% CI = 1.07-1.57), consistent with non-dialysis CKD studies. Discrimination was moderate for RDW alone (AUC = 0.696) and improved in the multivariable model (AUC = 0.774). An exploratory cutoff of 14.8% yielded a sensitivity of 78.6% and a specificity of 59.8%. Conclusions Elevated RDW is an independent predictor of in-hospital mortality in advanced hospitalized CKD in an Indian tertiary setting, consistent with global evidence. Despite moderate discrimination, its value lies in being a low-cost, universally available marker that can facilitate early risk stratification, particularly in resource-limited settings with high sepsis and malnutrition burden. However, prospective external validation is warranted to confirm these findings.
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