Comparison of RDW-SD and RDW -CV in Chronic Kidney Disease Patients Before and After Hemodialysis

Dzaki Ahmad Fahrezi Amus (Departemen Patologi Klinik, Fakultas Kedokteran, Universitas Tadulako, Palu, 94119, Indonesia)
Haerani Harun (Program Studi Kedokteran, Fakultas Kedokteran, Universitas Tadulako, Palu, 94119, Indonesia)
Jeremy Tanan (Departemen Patologi Klinik, Fakultas Kedokteran, Universitas Tadulako, Palu, 94119, Indonesia)
Rahma (Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Universitas Tadulako, Palu, 94119, Indonesia)
Nur Syamsi (Departemen Farmakologi, Fakultas Kedokteran, Universitas Tadulako, Palu, 94119, Indonesia)
Christin Rony Nayoan (Departemen Farmakologi, Fakultas Kedokteran, Universitas Tadulako, Palu, 94119, Indonesia)

AVERROUS: Jurnal Kedokteran dan Kesehatan Malikussaleh
Averrous, Volume 12 No.1 Mei 2026

Red Cell Distribution Width (RDW) is a prognostic biomarker in chronic kidney disease (CKD), reported as RDW-SD (absolute) and RDW-CV (relative). This study directly compares changes in RDW-SD versus RDW-CV before and after a single hemodialysis (HD) session. This pre-post observational study involved 30 adult CKD patients undergoing routine HD. Blood samples were taken pre-HD and one hour post-HD. RDW-SD, RDW-CV, and other hematological parameters were analyzed using a hematology analyzer (Wilcoxon test). Median RDW-SD was 44.40 fL pre-HD vs. 43.80 fL post-HD (p=0.186); median RDW-CV was 14.35% pre-HD vs. 14.30% post-HD (p=0.052). Neither showed significant acute changes, although hemoglobin and leukocytes increased while platelets decreased. A single HD session does not significantly alter RDW-SD or RDW-CV, confirming both parameters reflect chronic disease status rather than acute procedural effects. Clinical implications: These preliminary findings suggest that RDW-SD and RDW-CV may be considered potential long-term prognostic markers, although this requires confirmation in larger studies.