红细胞分布宽度(red cell distribution width，RDW)是反映循环系统中红细胞体积异质性的参数，与红细胞平均体积(mean corpuscular volume，MCV)一起用于鉴别各种不同类型的贫血。近年的研究揭示了RDW 对急性肾损伤、肾移植以及慢性肾脏病患者的预后具有预测价值。RDW 可作为急慢性肾脏病患者预后的重要预测因子，其机制尚未阐明，可能是RDW 反映了一系列潜在的病理生理过程，在慢性肾脏病(chronic kidney disease，CKD)患者中，主要认为与贫血、炎症、营养不良、内皮功能障碍以及氧化应激有关。本文着重探讨RDW在CKD 发生发展中的研究进展。

Red cell distribution width (RDW) is a quantitative marker for the heterogeneity of red blood cell (RBC) in circulation. RDW is used along with mean corpuscular volume (MCV) for the differential diagnosis of anemia. Recent studies indicated that RDW may have strong predictive value for prognosis in patients with acute kidney injury, kidney transplantation and chronic kidney disease (CKD). However, the potential mechanism of RDW as an important predictor of prognosis in both acute and chronic kidney disease was not elucidated. It may reflect a series of potential pathophysiological processes. In patients with CKD, RDW was found to be related to anemia, inflammation, malnutrition, endothelial dysfunction and oxidative stress. This paper focuses on the update study results of RDW in CKD.