Abstract: 【Abstract】Objective To investigate the relationship between red blood cell distribution width (RDW) and acute heart failure (AHF)) in hemodialysis patients. Methods A total of 180 hemodialysis patients treated in the Blood Purification Center, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology were retrospectively analyzed. They were divided into AHF group (n=78) and non AHF group (n=102). Their general information and laboratory indexes were recruited and compared between the two groups. The correlation between AHF and RDW and other clinical indicators was analyzed. Results Patients in the AHF group had higher RDW (14.96±0.81)% as compared with that in the non-AHF group (t=-9.042, P<0.001). Pearson
correlation analysis showed that RDW (r=0.584, P<0.001) and hypersensitive C- reactive protein (r=0.219, P=0.003) were positively correlated with AHF, and albumin (r=0.159, P=0.033) was negatively correlated with AHF. Multivariate logistic regression analysis revealed that RDW (OR=5.763, 95% CI 3.334～9.961, P<0.001), albumin (OR=1.104, 95% CI 0.984～1.238, P=0.091), and hypersensitive C- reactive protein (OR=1.065, 95% CI 1.002～1.133, P=0.044) were the risk factors for AHF. ROC curve analysis found that the area under curve (AUC) of RDW for predicting AHF was 0.840, with the sensitivity of 74.4% and specificity
of 83.3%. Conclusion Higher RDW is a risk factor and a predictive indicator for hemodialysis patients complicated with AHF.

Key words: Red blood cell distribution width, Hemodialysis, Acute heart failure, Risk factor