Objective To investigate the correlation between red blood cell distribution width (RDW) and early-stage renal function damage in elderly patients with essential hypertension. Methods A total of 364 elderly patients with essential hypertension were recruited from July 2014 to December 2014 in hypertension outpatients of Xuanwu Hospital as the hypertension group, while 100 consecutive healthy subjects were enrolled as the control group. Age, gender, SBP, DBP, BMI, FPG, TG, TC, LDL-C, HDL-C, UA, SCr, BUN, urine protein consentration and complete blood count (CBC) were documented in all individuals. Renal function was evaluated by estimated glomerular filtration rate (eGFR) and calculated by MDRD formula in 364 elderly patients with hypertension, whom were further divided into two groups according to eGFR values: renal function deficient group (eGFR ﹤ 90 ml.min - 1.1. 73 m - 2 , n = 102) and non-deficient group (eGFR≥90 ml.min - 1.1. 73 m - 2 , n = 262). Results (1) Compared with control group, the hypertension group was significantly higher in BMI [(25. 84 ± 2. 95) kg/ m2 vs. (23. 79 ± 3. 12) kg/ m2 ], TC [(1. 96 ± 1. 34) mmol/ L vs. (1. 58 ± 0. 69) mmol/ L], UA [(325. 37 ± 88. 97) mmol/ L vs. (296. 63 ± 80. 11)mmol/ L] and RDW (13. 05% ± 0. 87% vs. 12. 59% ± 0. 61% ), but significantly lower in HDL-C [(1. 43 ± 0. 38) mmol/ L vs. (1. 61 ± 0. 33) mmol/ L], eGFR [(104. 63 ± 28. 47) ml.min - 1. 1. 73 m - 2 vs. (124. 49 ± 25. 96) ml.min - 1.1. 73 m - 2 ] (all P ﹤ 0. 05). (2) In hypertensive patients, eGFR abnormal group showed significant differences compared with eGFR normal group in follows: age [(62. 6 ± 9. 3)years old vs. (59. 9 ± 8. 8) years old], BMI [(26. 99 ± 3. 05) kg/ m2 vs. (25. 39 ± 2. 78) kg/ m2 ], SBP [(163. 44 ± 15. 18) mmHg vs. (154. 42 ± 12. 27) mmHg], hypertension course [(12. 4 ± 3. 7)years vs. (9. 8 ± 3. 6)years], UA [(358. 84 ± 97. 93) mmol/ L vs. (312. 34 ± 81. 79) mmol/ L], SCr [(87. 56 ± 21. 16) μmol/ L vs. (58. 60 ± 11. 01) μmol/ L], urine protein positive rate (46. 10% vs. 21. 00% ) and RDW (13. 45% ± 0. 94% vs. 12. 90% ± 0. 79% ) were significantly higher, while eGFR [(73. 85 ± 12. 32) ml.min - 1.1. 73 m - 2 vs. (116. 61 ± 23. 54) ml.min - 1.1. 73 m - 2 ]significantly lower (all P ﹤ 0. 05). Pearson correlation analysis showed that RDW was negatively correlated with eGFR (r = -0. 237, P = 0. 000). Logistic multivariate regression analysis showed that RDW was an independent predictor of eGFR (OR = 1. 485, P = 0. 015). Conclusions RDW is negatively correlated with eGFR in elderly patients with essential hypertension. RDW may be used as a predictive factor of early renal damage in elderly patients with essential hypertension.%目的：探讨老年原发性高血压患者红细胞分布宽度(RDW)与早期肾功能损害的关系。方法入选2014年7~12月首都医科大学宣武医院高血压门诊364例老年原发性高血压患者作为观察组,另连续选取100名同期年龄匹配的体检健康者作为对照组,记录两组年龄、性别、收缩压、舒张压、体质指数(BMI)、空腹血糖(FPG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、尿酸、肌酐、尿素氮、尿蛋白定性及血常规等。采用肾脏病饮食改良(MDRD)简化公式计算估算肾小球滤过率(eGFR),根据 eGFR 水平将高血压组患者分为两组：eGFR 下降组( eGFR ﹤90 ml.min -1.1.73 m -2)102例与 eGFR 正常组( eGFR≥90 ml.min -1.1.73 m -2)262例。并比较 RDW、eGFR、BMI 和生化指标等参数在各组间的变化差异,分析 RDW 与eGFR 的相关性。结果(1)与对照组比较,高血压组患者 BMI[(25.84±2.95) kg/ m2比(23.79±3.12) kg/ m2]、 TG [(1.96±1.34) mmol/ L 比(1.58±0.69) mmol/ L ]、血尿酸[(325.37±88.97)mmol/ L比(296.63±80.11) mmol/ L]和 RDW(13.05%±0.87%比12.59%±0.61%)水平升高,HDL-C[(1.43±0.38) mmol/ L 比(1.61±0.33) mmol/ L]和 eGFR[(104.63±28.47) ml.min -1.1.73 m -2比(124.49±25.96)ml.min -1.1.73 m -2]水平下降,差异均有统计学意义(均为 P ﹤0.05)；(2)在高血压患者中,与 eGFR 正常组比较,eGFR 下降组的年龄[(62.6±9.3)岁比(59.9±8.8)岁]、BMI[(26.99±3.05)kg/ m2比(25.39±2.78) kg/ m2]、收缩压[(163.44±15.18) mmHg 比(154.42±12.27)mmHg]、高血压病程[(12.4±3.7)年比(9.8±3.6)年]、血尿酸[(358.84±97.93)mmol/ L比(312.34±81.79)mmol/ L]、肌酐[(87.56±21.16)μmol/ L 比(58.60±11.01)μmol/ L]、尿蛋白阳性率(46.10%比21.00%)及 RDW(13.45%±0.94%比12.90%±0.79%)均升高,而 eGFR[(73.85±12.32)ml.min -1.1.73 m -2比(116.61±23.54)ml.min -1.1.73 m -2]下降,差异均有统计学意义(均为P ﹤0.05)；经 Pearson 相关分析显示,高血压组患者 RDW 与 eGFR 水平呈负相关(r =-0.237,P =0.000)；(3)Logistic 多元回归分析显示,RDW 是 eGFR 的危险因素(OR =1.485,P =0.015)。结论老年原发性高血压患者的 RDW 与 eGFR 呈负相关,RDW 可作为评估老年原发性高血压患者早期肾功能损害的预测因素。
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