A combinação da largura da distribuição de glóbulos vermelhos e do índice de massa corporal (COR-IMC) pode predizer mortalidade hospitalar em pacientes com disfunção renal em diferentes estágios?

Abstract

Introduction: The combination of red blood cell distribution width and body mass index (COR-BMI) has been shown to be a good predictor of mortality, but its validity in patients with kidney disease has not been investigated. Thus, the aim of this study is to evaluate its applicability in individuals with kidney disease. Methods: Cross-sectional study of 538 hospitalized renal patients between 2014 and 2016. COR-BMI was divided into three categories: 0: RDW ≤ 13.1 and BMI ≥ 25; 1: RDW ≤ 13.1 and BMI <18.5 or ≥ 18.5 and <25 and patients with RDW> 13.1 and BMI ≥ 18.5 and <25 or BMI ≥ 25; and 2: RDW> 13.1 and BMI <18.5. Glomerular filtration rate was calculated from the glomerular filtration rate estimation formula, after which the renal stage was classified as 1, 2, 3a, 3b, 4 and 5. Cox regression was used to determine independent predictors of hospital mortality. Results: The COR-BMI was a predictor of in-hospital mortality regardless of age, gender and renal stage (1 versus 0: HR = 2.59; CI = 1.03-6.48; 2 versus 0: HR = 5.89; CI = 1.75-19.8). The frequency of malnutrition was 62.3% (337) and the prevalence of death was 12.1% (65), of which 92.3% (60) were malnourished and 89.5% (51) were classified as COR-BMI scores 1 and 2. Conclusion: The facility of calculating BMI, and the low cost and almost universal availability of RDW, corroborate that BMI COR is a useful tool for prognosis of renal patients.